Sex- and the age-specific survival impacts of multiple body composition parameters in patients with gastroesophageal cancers

PURPOSE: This study aimed to evaluate the sex- and age-specific survival impacts of body composition (BC) parameters in patients with surgically treated gastroesophageal cancer. METHODS: A total of 1382 patients were retrospectively analyzed. The skeletal muscle index (SMI), skeletal muscle radiodensity (SMD), and visceral/subcutaneous adipose tissue index (VATI/SATI) were determined. The survival impacts of the BC parameters were investigated according to age (≥ 75 or < 75 years) and sex. Multivariate Cox hazard models were used to identify independent predictors of a poor overall survival (OS) and cancer-specific survival (CSS). RESULTS: The median age was 67 years, and 1028 (74.4%) patients were male. A low SMI (P < 0.001), a low SATI (P = 0.048), and a low SMD (P = 0.01) were independent predictors of poor OS in younger patients; however, only a low SMI (P < 0.001) had an independent impact on OS in the older group. In male patients, all four BC measures significantly demarcated OS curves (all P < 0.01), and a low SMI had an independent impact on CSS (P = 0.03). In contrast, in female patients, only SMI and SATI reliably discriminated OS curves (both P < 0.001), and a low SATI was an independent predictor of a poor CSS (P = 0.008). CONCLUSIONS: The prognostic implications of the BC parameters may vary by age and sex in patients with gastroesophageal cancer.