{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T18:58:21Z","timestamp":1793300301341,"version":"4.5.0"},"reference-count":54,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,1,9]],"date-time":"2018-01-09T00:00:00Z","timestamp":1515456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001602","name":"Science Foundation Ireland","doi-asserted-by":"publisher","award":["SFI\/12\/RC\/2273"],"award-info":[{"award-number":["SFI\/12\/RC\/2273"]}],"id":[{"id":"10.13039\/501100001602","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Malnutrition, weight loss, and muscle wasting are common in patients with foregut cancers (oesophagus, stomach, pancreas, liver, and bile ducts) and are associated with adverse clinical outcomes. However, little is known about the changes in body composition that occur in these patients during chemotherapy and its impacts clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>A prospective study of adult foregut cancer patients undergoing chemotherapy between 2012 and 2016 was conducted. Computed tomography images were evaluated for cross\u2010sectional skeletal muscle area (SMA) and adipose tissue area (ATA) at two time points [interval 118\u00a0days (IQR 92\u201358\u00a0days)]. Longitudinal changes in SMA and ATA were examined using paired <jats:italic>t<\/jats:italic>\u2010tests. Sarcopenia and low muscle attenuation (MA) were defined using published cut\u2010points. Cox proportional hazards models were used to estimate mortality hazard ratios for key predictors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 225 foregut cancer patients were included (67% male, median age 66\u00a0years). At baseline, 40% were sarcopenic, 49% had low MA, and 62% had cancer cachexia. Longitudinal analysis (<jats:italic>n<\/jats:italic>\u00a0=\u00a0163) revealed significant reductions in SMA [\u22126.1\u00a0cm<jats:sup>2<\/jats:sup> (3.9%)\/100\u00a0days, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001]. Patients treated with neoadjuvant chemotherapy experienced greater losses in SMA and skeletal muscle mass compared with patients receiving palliative chemotherapy [\u22126.6\u00a0cm<jats:sup>2<\/jats:sup> (95%, confidence interval, CI: \u221210.2 to \u22123.1), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001 and \u22121.2\u00a0kg (95% CI: \u22121.8 to \u22120.5), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001, respectively]. Neither sarcopenia nor low MA at baseline was associated with reduced survival. A loss of SMA &gt;6.0%\/100\u00a0days (highest fourth) independently predicted overall survival in patients receiving palliative chemotherapy [hazard ratio: 2.66, (95% CI: 1.42 to 4.97), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.002].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with foregut cancers, particularly those treated with neoadjuvant chemotherapy, experience significant losses of muscle during chemotherapy. A high level of SMA loss is prognostic of reduced survival in patients treated with palliative chemotherapy. Multimodal interventions to stabilize or increase muscle mass and influence outcome warrant further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12267","type":"journal-article","created":{"date-parts":[[2018,1,10]],"date-time":"2018-01-10T13:59:08Z","timestamp":1515592748000},"page":"315-325","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":190,"title":["Loss of skeletal muscle during systemic chemotherapy is prognostic of poor survival in patients with foregut cancer"],"prefix":"10.1002","volume":"9","author":[{"given":"Louise E.","family":"Daly","sequence":"first","affiliation":[{"name":"School of Food and Nutritional Sciences, College of Science, Engineering and Food Science University College Cork  Cork Ireland"},{"name":"APC Microbiome Institute University College Cork  Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c9adaoin B.","family":"N\u00ed Bhuachalla","sequence":"additional","affiliation":[{"name":"School of Food and Nutritional Sciences, College of Science, Engineering and Food Science University College Cork  Cork Ireland"},{"name":"Cork Cancer Research Centre University College Cork  Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek G.","family":"Power","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Mercy and Cork University Hospitals  Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha J.","family":"Cushen","sequence":"additional","affiliation":[{"name":"School of Food and Nutritional Sciences, College of Science, Engineering and Food Science University College Cork  Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"James","sequence":"additional","affiliation":[{"name":"Department of Radiology Cork University Hospital  Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aoife M.","family":"Ryan","sequence":"additional","affiliation":[{"name":"School of Food and Nutritional Sciences, College of Science, Engineering and Food Science University College Cork  Cork Ireland"},{"name":"Cork Cancer Research Centre University College Cork  Cork 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