ArticleWorld journal of surgery2023
A Novel Frailty Grade Combined with Cachexia Index and Osteopenia in Esophagectomy.
Article in World journal of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Cachexia Index in Patients with Gastrointestinal Cancer: A Systematic Review and Meta-Analysis.Journal of gastrointestinal cancer · 2024Pooled it
- Bone Loss, Osteoporosis, and Skeletal Fragility: Hidden Consequences of Cancer Cachexia.Cells · 2026Review
- Prognostic Impact of Cachexia Index in Patients Undergoing Surgery for Esophageal Cancer.Annals of surgical oncology · 2026Article
- Prognostic Impact of Osteopenia in Patients with Resectable Esophageal Adenocarcinoma: A Retrospective Study.Annals of surgical oncology · 2026Article
- Postoperative Complications in Patients with Frailty Syndrome Undergoing Esophagectomy-A Systematic Review with Meta-Analysis.Journal of clinical medicine · 2026Review
- MLM3 and MLM5 head and neck cancer models promote age-dependent musculoskeletal deterioration in mice.Scientific reports · 2025Article
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundsThe optimal method for evaluating frailty grade in patients with cancer has not been established in patients undergoing esophagectomy for esophageal cancer. This study aimed to clarify the impact of cachexia index (CXI) and osteopenia on survival in esophagectomized patients for esophageal cancer to develop frailty grade for risk stratification of the prognosis.
methodsA total of 239 patients who underwent esophagectomy were analyzed. CXI was calculated as follows: skeletal muscle index × serum albumin/neutrophil-to-lymphocyte ratio. Meanwhile, osteopenia was defined as below the cutoff value of bone mineral density (BMD) calculated by the receiver operating characteristic curve. We evaluated the average Hounsfield unit within a circle in the lower midvertebral core of the 11th thoracic vertebra on preoperative computed tomography as BMD.
resultsMultivariate analysis revealed that low CXI (Hazard ratio [HR], 1.95; 95% confidence interval [CI], 1.25-3.04) and osteopenia (HR, 1.86; 95% CI, 1.19-2.93) were independent prognostic factors for overall survival. Meanwhile, low CXI (HR, 1.58; 95% CI, 1.06-2.34) and osteopenia (HR, 1.57; 95% CI, 1.05-2.36) were also significant prognostic factors for relapse-free survival. A frailty grade combined with CXI and osteopenia stratified into four groups by their prognosis.
conclusionsLow CXI and osteopenia predict poor survival in patients undergoing esophagectomy for esophageal cancer. Furthermore, a novel frailty grade combined with CXI and osteopenia stratified the patients into four groups according to their prognosis.
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