Body Composition in Relation to Postoperative Anastomotic Leakage and Overall Survival in Patients with Esophageal Cancer

Abstract Background Body composition was reported to be related to the prognosis of cancer patients. This study was aimed to investigate the influence of preoperative body composition on anastomotic leakage and overall survival in patients with esophageal cancer. Methods In this retrospective study, 93 patients with esophageal cancers were evaluated. Skeletal muscle area (SMA), intermuscular adipose tissue (IMAT), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) were measured on CT images at the level of the third lumbar vertebra. Subsequently, each body composition index was also calculated by dividing the body composition by the square of the height. The cutoff values of body compositions were defined using X-tile software. Univariate and multivariate analyses were performed to evaluate the risk factors of anastomotic leakage. Kaplan-Meier method and Cox regression analysis were used to evaluate the risk factors of overall survival (OS). Results VAT and visceral fat index (VFI) were higher in patients with anastomotic fistula than those without anastomotic fistula, but none of them were independent risk factors. Patients with higher body mass index (BMI), higher VFI, and higher subcutaneous fat index (SFI) had better overall survival. By multivariate analysis, SFI >27.6 cm2/m2 was still significantly associated with OS. Conclusion Patients with higher VAT and VFI were prone to have an anastomotic leakage. Lower BMI, VFI, and SFI were associated with a reduction in overall survival.