{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T04:49:46Z","timestamp":1780548586137,"version":"3.54.1"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T00:00:00Z","timestamp":1730851200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>In older patients with locally advanced esophageal cancer (LAEC), loss of skeletal muscle mass during neoadjuvant chemotherapy (NAC) is associated with poor clinical outcomes. This study aimed to investigate factors associated with loss of skeletal muscle mass during NAC in older patients with LAEC. This was a single-center exploratory prospective cohort study. Consecutive patients aged \u226565\u00a0years with LAEC scheduled for curative esophagectomy after NAC were enrolled between October 2021 and December 2023. As a primary endpoint, loss of skeletal muscle mass index (\u0394SMI: pre-NAC minus post-NAC value) was calculated from computed tomography images before and after NAC. Significant pre-NAC and during-NAC factors with \u0394SMI were detected with a multivariate regression model. Statistical significance was considered as two-tailed P &amp;lt;0.05. A total of 69 patients were analyzed. The mean age was 72.9\u00a0years, and 53 (77%) were male. Mean SMI before and after NAC was 43.1 and 40.9\u00a0cm2\/m2, and mean \u0394SMI was 2.2\u00a0cm2\/m2. In multivariate analysis, \u0394SMI was associated with increased sitting time during NAC (per 1\u00a0min\/day, adjusted coefficient 0.007, 95% confidence interval [CI] 0.001 to 0.013, P\u2009=\u20090.016), decreased Geriatric Nutritional Risk Index during NAC (per 1 score, adjusted coefficient \u22120.146, 95% CI \u22120.213 to \u22120.013, P\u2009=\u20090.002), and worsening decreased appetite during NAC (vs. no worsening, adjusted coefficient 1.571, 95% CI 0.279 to 2.862, P\u2009=\u20090.018). It was hypothesized that the inactivity-related mechanism and malnutrition-related mechanism are important for skeletal muscle mass loss during NAC in older patients with LAEC.<\/jats:p>","DOI":"10.1093\/dote\/doae096","type":"journal-article","created":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T21:26:48Z","timestamp":1730842008000},"source":"Crossref","is-referenced-by-count":9,"title":["Clinical mechanism of muscle mass loss during neoadjuvant chemotherapy in older patients with esophageal cancer: a prospective cohort study"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4459-8262","authenticated-orcid":false,"given":"Tsuyoshi","family":"Harada","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, National Cancer Center Hospital East , Kashiwa, Chiba,","place":["Japan"]},{"name":"Department of Rehabilitation Medicine, Keio University Graduate School , Shinjuku, Tokyo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Tsuji","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, National Cancer Center Hospital East , Kashiwa, Chiba,","place":["Japan"]},{"name":"Department of Rehabilitation Medicine, Keio University School of Medicine , Shinjuku, Tokyo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junya","family":"Ueno","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, National Cancer Center Hospital East , Kashiwa, Chiba,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuko","family":"Konishi","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, National Cancer Center Hospital East , Kashiwa, Chiba,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takumi","family":"Yanagisawa","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, National Cancer Center Hospital East , Kashiwa, Chiba,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanako","family":"HIjikata","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, National Cancer Center Hospital East , Kashiwa, Chiba,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiko","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, National Cancer Center Hospital East , Kashiwa, Chiba,","place":["Japan"]},{"name":"Department of Rehabilitation Medicine, Keio University School of Medicine , Shinjuku, Tokyo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kakeru","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, National Center for Geriatrics and Gerontology , Obu, Aichi,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Kagaya","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, National Center for Geriatrics and Gerontology , Obu, Aichi,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriatsu","family":"Tatematsu","sequence":"additional","affiliation":[{"name":"Department of Integrated Health Sciences, Nagoya University , Nagoya, Aichi,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadamoto","family":"Zenda","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center Hospital East , Kashiwa, Chiba,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Kotani","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology, National Cancer Center Hospital East , Kashiwa, Chiba,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kojima","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology, National Cancer Center Hospital East , Kashiwa, Chiba,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeo","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Esophageal Surgery, National Cancer Center Hospital East , Kashiwa, Chiba,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,11,5]]},"reference":[{"key":"2025101516113622100_ref1","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1053\/j.gastro.2020.02.068","article-title":"Global burden of 5 major types of gastrointestinal cancer","volume":"159","author":"Arnold","year":"2020","journal-title":"Gastroenterology"},{"key":"2025101516113622100_ref2","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1245\/s10434-011-2049-9","article-title":"A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907)","volume":"19","author":"Ando","year":"2012","journal-title":"Ann Surg Oncol"},{"key":"2025101516113622100_ref3","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/S1470-2045(11)70142-5","article-title":"Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma: an updated meta-analysis","volume":"12","author":"Sjoquist","year":"2011","journal-title":"Lancet Oncol"},{"key":"2025101516113622100_ref4","doi-asserted-by":"crossref","first-page":"8131","DOI":"10.1245\/s10434-022-12379-2","article-title":"Prognostic impact of the loss of skeletal muscle mass during neoadjuvant chemotherapy on older patients with esophageal cancer","volume":"29","author":"Harada","year":"2022","journal-title":"Ann Surg Oncol"},{"key":"2025101516113622100_ref5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/dote\/dox018","article-title":"Reduced fitness and physical functioning are long-term sequelae after curative treatment for esophageal cancer: a matched control study","volume":"30","author":"Gannon","year":"2017","journal-title":"Dis Esophagus"},{"key":"2025101516113622100_ref6","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1002\/bjs.10577","article-title":"Meta-analysis of health-related quality of life after minimally invasive versus open oesophagectomy for oesophageal cancer","volume":"104","author":"Kauppila","year":"2017","journal-title":"Br J Surg"},{"key":"2025101516113622100_ref7","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1016\/S2468-1253(20)30007-8","article-title":"The global, regional, and national burden of oesophageal cancer and its attributable risk factors in 195 countries and territories, 1990\u20132017: a systematic analysis for the global burden of disease study 2017","volume":"5","author":"Kamangar","year":"2020","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2025101516113622100_ref8","doi-asserted-by":"crossref","first-page":"2326","DOI":"10.1200\/JCO.2018.78.8687","article-title":"Practical assessment and management of vulnerabilities in older patients receiving chemotherapy: ASCO guideline for geriatric oncology","volume":"36","author":"Mohile","year":"2018","journal-title":"J Clin Oncol"},{"key":"2025101516113622100_ref9","doi-asserted-by":"crossref","first-page":"2595","DOI":"10.1200\/JCO.2013.54.8347","article-title":"International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer","volume":"32","author":"Wildiers","year":"2014","journal-title":"J Clin Oncol"},{"key":"2025101516113622100_ref10","doi-asserted-by":"crossref","first-page":"e29","DOI":"10.1016\/S1470-2045(20)30473-3","article-title":"Priorities for the global advancement of care for older adults with cancer: an update of the International Society of Geriatric Oncology Priorities Initiative","volume":"22","author":"Extermann","year":"2021","journal-title":"Lancet Oncol"},{"key":"2025101516113622100_ref11","doi-asserted-by":"crossref","first-page":"2636","DOI":"10.1016\/S0140-6736(19)31138-9","article-title":"Sarcopenia","volume":"393","author":"Cruz-Jentoft","year":"2019","journal-title":"Lancet"},{"key":"2025101516113622100_ref12","doi-asserted-by":"crossref","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","article-title":"Frailty in older adults: evidence for a phenotype","volume":"56","author":"Fried","year":"2001","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2025101516113622100_ref13","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1136\/spcare-2023-004245","article-title":"Skeletal muscle mass recovery after oesophagectomy and neoadjuvant chemotherapy in oesophageal cancer: retrospective cohort study","volume":"14","author":"Harada","year":"2023","journal-title":"BMJ Support Palliat Care"},{"key":"2025101516113622100_ref14","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1139\/H08-075","article-title":"A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care","volume":"33","author":"Mourtzakis","year":"2008","journal-title":"Appl Physiol Nutr Metab"},{"key":"2025101516113622100_ref15","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1136\/thx.47.12.1019","article-title":"Development of a shuttle walking test of disability in patients with chronic airways obstruction","volume":"47","author":"Singh","year":"1992","journal-title":"Thorax"},{"key":"2025101516113622100_ref16","volume-title":"Measuring health and disability: Manual for WHO disability assessment schedule WHODAS 2.0","author":"\u00dcst\u00fcn","year":"2010"},{"key":"2025101516113622100_ref17","doi-asserted-by":"crossref","first-page":"2166","DOI":"10.1093\/annonc\/mdr587","article-title":"Screening older cancer patients: first evaluation of the G-8 geriatric screening tool","volume":"23","author":"Bellera","year":"2012","journal-title":"Ann Oncol"},{"key":"2025101516113622100_ref18","doi-asserted-by":"crossref","first-page":"3457","DOI":"10.1200\/JCO.2011.34.7625","article-title":"Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study","volume":"29","author":"Hurria","year":"2011","journal-title":"J Clin Oncol"},{"key":"2025101516113622100_ref19","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1007\/s10389-006-0024-x","article-title":"Development of the World Health Organization Global Physical Activity Questionnaire (GPAQ)","volume":"14","author":"Armstrong","year":"2006","journal-title":"J Public Health"},{"key":"2025101516113622100_ref20","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1093\/ajcn\/82.4.777","article-title":"Geriatric nutritional risk index: a new index for evaluating at-risk elderly medical patients","volume":"82","author":"Bouillanne","year":"2005","journal-title":"Am J Clin Nutr"},{"key":"2025101516113622100_ref21","author":"Guidance for Industry Patient-Reported Outcome Measures: Use in Medical Product Development to Support Labeling Claims"},{"key":"2025101516113622100_ref22","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.1002\/jcsm.13323","article-title":"Diagnosis and outcomes of cachexia in Asia: working consensus report from the Asian Working Group for Cachexia","volume":"14","author":"Arai","year":"2023","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"2025101516113622100_ref23","doi-asserted-by":"crossref","first-page":"101580","DOI":"10.1016\/j.jgo.2023.101580","article-title":"Association of sarcopenia with relative dose intensity of neoadjuvant chemotherapy in older patients with locally advanced esophageal cancer: a retrospective cohort study","volume":"14","author":"Harada","year":"2023","journal-title":"J Geriatr Oncol"},{"key":"2025101516113622100_ref24","doi-asserted-by":"crossref","first-page":"8438","DOI":"10.1245\/s10434-021-10221-9","article-title":"Prognostic significance of stratification using pathological stage and response to neoadjuvant chemotherapy for esophageal squamous cell carcinoma","volume":"28","author":"Matsuda","year":"2021","journal-title":"Ann Surg Oncol"},{"key":"2025101516113622100_ref25"},{"key":"2025101516113622100_ref26","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1007\/s00595-015-1236-x","article-title":"Extended Clavien-Dindo classification of surgical complications: Japan Clinical Oncology Group postoperative complications criteria","volume":"46","author":"Katayama","year":"2016","journal-title":"Surg Today"},{"key":"2025101516113622100_ref27","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1093\/ageing\/afz046","article-title":"Sarcopenia: revised European consensus on definition and diagnosis","volume":"48","author":"Cruz-Jentoft","year":"2019","journal-title":"Age Ageing"},{"key":"2025101516113622100_ref28","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1200\/JCO.21.00102","article-title":"Sarcopenia in the older adult with cancer","volume":"39","author":"Williams","year":"2021","journal-title":"J Clin Oncol"},{"key":"2025101516113622100_ref29","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1002\/jcsm.13414","article-title":"A single chemotherapy administration induces muscle atrophy, mitochondrial alterations and apoptosis in breast cancer patients","volume":"15","author":"Mallard","year":"2024","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"2025101516113622100_ref30","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1002\/jcsm.13073","article-title":"Molecular mechanisms of cancer cachexia-related loss of skeletal muscle mass: data analysis from preclinical and clinical studies","volume":"14","author":"Martin","year":"2023","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"2025101516113622100_ref31","doi-asserted-by":"crossref","first-page":"235","DOI":"10.3389\/fphys.2018.00235","article-title":"Muscle atrophy induced by mechanical unloading: mechanisms and potential countermeasures","volume":"9","author":"Gao","year":"2018","journal-title":"Front Physiol"},{"key":"2025101516113622100_ref32","doi-asserted-by":"crossref","first-page":"C1068","DOI":"10.1152\/ajpcell.00425.2021","article-title":"Disuse-induced skeletal muscle atrophy in disease and nondisease states in humans: mechanisms, prevention, and recovery strategies","volume":"322","author":"Nunes","year":"2022","journal-title":"Am J Physiol Cell Physiol"},{"key":"2025101516113622100_ref33","doi-asserted-by":"crossref","first-page":"835","DOI":"10.2147\/CIA.S132940","article-title":"Relationship between sarcopenia and physical activity in older people: a systematic review and meta-analysis","volume":"12","author":"Steffl","year":"2017","journal-title":"Clin Interv Aging"},{"key":"2025101516113622100_ref34","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/s12904-020-00542-z","article-title":"Fatigue, barriers to physical activity and predictors for motivation to exercise in advanced cancer patients","volume":"19","author":"Frikkel","year":"2020","journal-title":"BMC Palliat Care"},{"key":"2025101516113622100_ref35","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1111\/cas.12486","article-title":"Phase I\/II trial of 2-weekly docetaxel combined with cisplatin plus fluorouracil in metastatic esophageal cancer (JCOG0807)","volume":"105","author":"Hironaka","year":"2014","journal-title":"Cancer Sci"},{"key":"2025101516113622100_ref36","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1097\/JTO.0b013e3181c1ffd5","article-title":"Phase I\/II study of docetaxel\/cisplatin\/fluorouracil combination chemotherapy against metastatic esophageal squamous cell carcinoma","volume":"5","author":"Takahashi","year":"2010","journal-title":"J Thorac Oncol"},{"key":"2025101516113622100_ref37","first-page":"210","article-title":"Adverse effects of systemic cancer therapy on skeletal muscle: myotoxicity comes out of the closet","volume":"26","author":"Klassen","year":"2023","journal-title":"Curr Opin Clin Nutr Metab Care"},{"key":"2025101516113622100_ref38","doi-asserted-by":"crossref","first-page":"2438","DOI":"10.1200\/JCO.20.00611","article-title":"Management of cancer cachexia: ASCO guideline","volume":"38","author":"Roeland","year":"2020","journal-title":"J Clin Oncol"},{"key":"2025101516113622100_ref39","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1080\/01635581.2015.1073753","article-title":"An epidemiological survey of cachexia in advanced cancer patients and analysis on its diagnostic and treatment status","volume":"67","author":"Sun","year":"2015","journal-title":"Nutr Cancer"},{"key":"2025101516113622100_ref40","doi-asserted-by":"crossref","first-page":"7226","DOI":"10.1245\/s10434-023-14192-x","article-title":"Research priorities in prehabilitation for patients undergoing cancer surgery: an international Delphi study","volume":"30","author":"Raichurkar","year":"2023","journal-title":"Ann Surg Oncol"},{"key":"2025101516113622100_ref41","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1007\/s10388-024-01075-7","article-title":"The implementation status of prehabilitation during neoadjuvant chemotherapy for patients with locally advanced esophageal cancer: a questionnaire survey to the board-certified facilities in Japan","volume":"21","author":"Harada","year":"2024","journal-title":"Esophagus"}],"container-title":["Diseases of the Esophagus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/dote\/article-pdf\/38\/1\/doae096\/60431052\/doae096.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/dote\/article-pdf\/38\/1\/doae096\/60431052\/doae096.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T20:11:49Z","timestamp":1760559109000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/dote\/article\/doi\/10.1093\/dote\/doae096\/7876387"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,5]]},"references-count":41,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1,7]]}},"URL":"https:\/\/doi.org\/10.1093\/dote\/doae096","relation":{},"ISSN":["1120-8694","1442-2050"],"issn-type":[{"value":"1120-8694","type":"print"},{"value":"1442-2050","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,2]]},"published":{"date-parts":[[2024,11,5]]},"article-number":"doae096"}}