Supplementary Table 1 Relationship between baseline anthropometry and body composition among all patients with locally advanced esophageal cancer treated with multimodal therapy
All patients n = 252
No Visceral Obesity n = 135
Visceral Obesity
n = 102 P-value
No Sarcopenia n = 190
Sarcopenia
n = 36 P-value
Body weight, kg, mean (SD) 77.2 (16.9) 70.8 (12.8) 86.4 (14.5) <0.001 78.9 (15.6) 69.4 (11.0) <0.001 BMI, mean (SD) 26.8 (5.0) 24.7 (3.7) 29.6 (4.1) <0.001 27.5 (4.5) 23.1 (3.1) <0.001 BMI category, N (%)
Underweight Normal weight Overweight Obese Not recorded
17 (6.7) 72 (28.6) 86 (34.1) 61 (24.2) 16 (6.3)
11 (8.1) 58 (42.9) 46 (34.1) 11 (8.1)
9 (6.7)
1 (1.0) 13 (12.7) 36 (35.3) 47 (46.1) 5 (4.9)
<0.001 6 (3.2) 50 (26.3) 73 (38.4) 55 (28.9) 6 (3.2)
6 (16.7) 17 (47.2)
9 (25.0) 0 (0.0) 4 (11.1)
<0.001
Morbid obesity, N (%) 7 (3.2) 1 (0.8) 6 (6.2) 0.02 7 (3.8) 0 (0.0) 0.26
Sarcopenia, N (%) 36 (15.9)
Visceral obesity, N (%) 102 (43.0) Sarcopenic obesity
[BMI], N (%) 0 (0.0) Sarcopenic obesity
[CT], N (%) 14 (6.3)
BMI, body mass index (kg/m2); obesity, BMI >30kg/m2; morbid obesity, BMI >40kg/m2 or >35kg/m2 with obesity-related comorbidity; Sarcopenic obesity[BMI],
sarcopenia + BMI >30kg/m2;Sarcopenic obesity[CT], sarcopenia + visceral obesity
Supplementary Table 2 Multivariate logistic regression analysis of factors predictive of specific postoperative morbidity after neoadjuvant therapy
≥IIIb PPC Pneumonia Prolonged intubation
P-value OR
(95% CI) P-value OR
(95% CI) P-value OR
(95% CI) P-value OR
(95% CI) Clinical characteristics
Age, years 0.85 0.10 0.36 0.80
Sex, male vs. female 0.67 0.22 0.58 0.29
Ever smoker 0.36 0.56 0.41 0.45
Current smoker 0.51 0.66 0.47 0.53
Diabetes 0.79 0.49 0.93 0.89
Cardiovascular
comorbidity 0.59 0.30 0.22 0.19
Respiratory comorbidity 0.17 0.32 0.36 0.31
ASA grade
ASA II-III vs. ASA I 0.008 3.66 (1.41 –
9.49) 0.16 0.095 0.001 7.38 (2.25 –
23.15) Neoadjuvant therapy
CRT vs. CT 0.64 0.24 0.59 0.27
Operation type† 0.40 0.29 0.66 0.07
Pathologic characteristics Histologic type
SCC vs. ADC 0.98 0.18 0.15
0.60 Clinical Stage 0.001 0.20 (0.07 –
0.57)
0.13 0.18 0.003 0.18 (0.06 –
0.56)
Pathologic T stage† 0.12 0.88 0.89 0.20
Pathologic N stage 0.68 0.27 0.39 0.82
pCR 0.008 4.47 (1.48 –
13.54)
0.09 0.051 0.02 4.45 (1.24 –
15.95) Body composition
Body weight, kg 0.80 0.27 0.80 0.73
BMI, kg/m2 0.69 0.39 0.72 0.92
BMI category† 0.52 0.68 0.80 0.85
Sarcopenia 0.001 5.30 (1.94 –
14.45)
0.023 2.17 (1.12 – 4.23)
0.015 2.33 (1.18 – 4.61)
0.019 3.83 (1.24 – 11.79)
Visceral obesity 0.63 0.11 0.08 0.35
Lean body mass 0.58 0.26 0.80 0.95
Fat mass 0.99 0.50 0.74 0.60
OR, odds ratio; CI, confidence interval; BMI, body mass index (kg/m2); obesity, BMI >30kg/m2; morbid obesity, BMI >40kg/m2 or >35kg/m2 with obesity-related comorbidity; ASA, American Society for Anesthesiologists; CCI, comprehensive complications index; CT, chemotherapy;
CRT, chemoradiation
†Analysed as a categorical variable, category P-values and Hazard Ratios not significant.
Supplementary Table 3 Multiple linear regression analysis of factors predictive of comprehensive complications index among patients undergoing esophagectomy after neoadjuvant therapy
P-value β-Coefficient (SE) 95% CI Clinical characteristics
Age, years 0.025 0.33 (0.15) 0.04 – 0.61
Sex, male vs. female 0.55
Ever smoker 0.69
Current smoker 0.38
Diabetes 0.33
Cardiovascular comorbidity 0.26
Respiratory comorbidity 0.43
ASA grade
ASA II-III vs. ASA I 0.006 7.65 (2.77) 2.18 – 13.12
Neoadjuvant therapy
CRT vs. CT 0.54
Operation type† 0.13
Pathologic characteristics Histologic type
SCC vs. adenocarcinoma 0.31
Clinical Stage 0.007 -7.65 (2.82) -13.22 – -2.08
Pathologic T stage† 0.56
Pathologic N stage† 0.96
pCR 0.004 10.72 (3.66) 3.49 – 17.94
Body composition
Body weight, kg 0.16
Body mass index, kg/m2 0.26
BMI category† 0.37
Sarcopenia 0.004 9.08 (3.11) 2.94 – 15.21
Visceral obesity 0.45
Lean body mass 0.61
Fat mass 0.43
BMI, body mass index (kg/m2); ASA, American Society for Anesthesiologists; CT, chemotherapy; CRT, chemoradiation; SE, standard error; 95% CI, 95% confidence interval
† Analysed as a categorical variable, category P-values and Hazard Ratios not significant.
Supplementary Table 4 Multivariate analysis of factors associated with survival outcome in resected multimodal population
Disease-free survival Disease-specific survival P-value HR (95% CI) P-value HR (95% CI)
Clinical characteristicsAge, years 0.45 0.63
Sex, male vs. female 0.21 0.52
Ever smoker 0.72 0.98
Current smoker 0.98 0.41
Diabetes 0.67 0.99
Cardiovascular comorbidity 0.53 0.88
Respiratory comorbidity 0.82 0.82
ASA grade
ASA II-III vs. ASA I 0.53 0.67
Neoadjuvant therapy
CRT vs. CT 0.14 0.24
Operation type† 0.47 0.46
Comprehensive complications index 0.90 0.93
Major complication (≥IIIb) 0.060 0.26
Pathologic characteristics Histologic type
SCC vs. adenocarcinoma 0.68 0.66
Clinical T stage
T3-4 vs. T1-2 0.43 0.013 6.10 (1.47 – 25.35)
Clinical N stage† 0.57 0.25
Pathologic T stage† 0.47 0.39
Pathologic N stage N1 vs. N0 N2 vs. N0 N3 vs. N0
<0.001
<0.001
<0.001
<0.001
2.91 (1.67 – 5.08) 5.42 (2.61 – 11.21) 5.07 (2.61 – 9.87)
<0.001
<0.001
<0.001
<0.001
3.66 (1.78 – 7.53) 9.65 (3.86 – 24.10) 9.33 (4.28 – 20.34)
Tumor regression grade† 0.17 0.070
pCR 0.15 0.29
R0 resection 0.15 0.18
Body composition
Body weight, kg 0.46 0.38
BMI, kg/m2 0.41 0.41
Baseline
Sarcopenia 0.44 0.98
Visceral obesity 0.43 0.31
Lean body mass 0.42 0.50
Fat mass 0.83 0.73
Preoperative
Sarcopenia 0.85 0.86
Visceral obesity 0.14 0.22
Lean body mass 0.28 0.42
Fat mass 0.69 0.49
Loss of lean body mass 0.58 0.53
HR, hazard ratio; CI, confidence interval; BMI, body mass index (kg/m2); obesity, BMI >30kg/m2; morbid obesity, BMI >40kg/m2 or >35kg/m2 with obesity-related comorbidity; ASA, American Society for Anesthesiologists; CCI, comprehensive complications index; CT, chemotherapy;
CRT, chemoradiation
†Analysed as a categorical variable, category P-values and Hazard Ratios not significant.
