It is known that various factors, including surgical stress, nutritional deficits and sarcopenia, affect the incidence of postoperative complications. The aim of this study is to identify the predictors of major complications (Clavien-Dindo ≥II) after esophageal resection following neoadjuvant chemotherapy (NAC). Methods Forty-nine patients with esophageal cancer undergoing NAC and surgery between January 2017 and December 2019 were identified from our surgery database and retrospectively analyzed. Onodera prognostic nutritional index (PNI) was used as the indicator of nutritional status. For the evaluation of skeletal muscle mass, computed tomography imaging of the total cross-sectional muscle tissue measured at the third lumbar level defined the skeletal muscle index (SMI). Images were collected before and after NAC. Univariate and multivariate logistic regression analyses were used to assess the association between various predictors and major postoperative complications. Results Of the Forty-nine patients, 20 patients (40.8%) had major complication after surgery. Of the 20 patients, 5 had pneumonia and 4 had anastomotic leakage. Nine patients (18.3%) complete planned dose of NAC. SMI reduction was observed in 42 patients (85.7%) during NAC. According to univariate analysis, SMI reduction during NAC, and PNI before chemotherapy were significantly associated with major postoperative complications (P = 0.032, P = 0.035, respectively). According to multivariate analysis, SMI reduction during NAC is an independent predictor for the incidence of major postoperative complications (P = 0.0034). Conclusion Skeletal muscle loss during neoadjuvant chemotherapy can be an useful predictor of major postoperative complications in patients with esophageal cancer.

中文翻译：

---

170 新辅助化疗期间的骨骼肌损失是食管癌患者术后主要并发症的预测指标

众所周知，各种因素，包括手术压力、营养缺乏和肌肉减少症，都会影响术后并发症的发生率。本研究的目的是确定新辅助化疗 (NAC) 后食管切除术后主要并发症 (Clavien-Dindo ≥II) 的预测因素。方法从我们的手术数据库中确定2017年1月至2019年12月接受NAC和手术的49例食管癌患者并进行回顾性分析。Onodera 预后营养指数（PNI）被用作营养状况的指标。为了评估骨骼肌质量，在第三腰椎水平测量的总横截面肌肉组织的计算机断层扫描成像定义了骨骼肌指数 (SMI)。在 NAC 之前和之后收集图像。单变量和多变量逻辑回归分析用于评估各种预测因素与主要术后并发症之间的关联。结果49例患者中，20例（40.8%）患者术后出现严重并发症。20 例患者中，5 例为肺炎，4 例为吻合口漏。9 名患者 (18.3%) 完成了 NAC 的计划剂量。在 NAC 期间，42 名患者 (85.7%) 观察到 SMI 降低。根据单因素分析，NAC 期间 SMI 降低和化疗前 PNI 与主要术后并发症显着相关（分别为 P = 0.032，P = 0.035）。根据多变量分析，NAC 期间 SMI 降低是主要术后并发症发生率的独立预测因子（P = 0.0034）。