Combined low muscle mass and body mass index for prognosis in esophageal squamous cell carcinoma patients receiving immunochemoradiotherapy

Table 1 Participant baseline characteristics stratified by low muscle mass, n (%)/mean ± SD

Characteristics	Overall	NMM	LMM	P value
n	105	57	48	-
Sex				0.001
Female	18 (17.1)	16 (15.2)	2 (1.9)
Male	87 (82.9)	41 (39)	46 (43.8)
Age, median (IQR)	65 (58, 69)	66 (61, 69)	64 (58, 69)	0.434
Smoking history				0.002
No	34 (32.4)	26 (24.8)	8 (7.6)
Yes	71 (67.6)	31 (29.5)	40 (38.1)
Alcoholhistory				0.075
No	38 (36.2)	25 (23.8)	13 (12.4)
Yes	67 (63.8)	32 (30.5)	35 (33.3)
Tumorlocation				0.825
Cervical	15 (14.3)	9 (8.6)	6 (5.7)
Upper thoracic	26 (24.8)	15 (14.3)	11 (10.5)
Middle thoracic	43 (41.0)	21 (20.0)	22 (21.0)
Lower thoracic	21 (20.0)	12 (11.4)	9 (8.6)
T				0.212
1	1 (1.0)	0 (0.0)	1 (1.0)
2	3 (2.9)	3 (2.9)	0 (0.0)
3	89 (84.8)	49 (46.7)	40 (38.1)
4	12 (11.4)	5 (4.8)	7 (6.7)
N				0.051
0	1 (1.0)	1 (1.0)	0 (0.0)
1	17 (16.2)	13 (12.4)	4 (3.8)
2	63 (60.0)	34 (32.4)	29 (27.6)
3	24 (22.9)	9 (8.6)	15 (14.3)
TNM				0.482
III	82 (78.1)	46 (43.8)	36 (34.3)
IV	23 (21.9)	11 (10.5)	12 (11.4)
WBC, median (IQR)	6.05 (5.13, 7.27)	6.02 (5.15, 7.42)	6.05 (5.07, 7.24)	0.714
HGB, median (IQR)	130 (120, 141)	133 (120, 141)	127 (120, 138)	0.214
PLT, median (IQR)	199 (159, 237)	194 (147, 233)	205.5 (161, 250)	0.320
NC, median (IQR)	4.10 (3.05, 5.24)	4.11 (3.15, 5.28)	4.09 (2.95, 5.22)	0.700
LC	1.36 ± 0.48	1.35 ± 0.46	1.37 ± 0.51	0.841
MC, median (IQR)	0.43 (0.32, 0.52)	0.425 (0.31, 0.56)	0.44 (0.32, 0.50)	0.860
ALB	38.20 ± 3.28	38.92 ± 3.35	37.35 ± 3.00	0.014
PA	195.11 ± 46.84	203.05 ± 51.46	185.67 ± 39.13	0.058
Triglycerides, median (IQR)	1.15 (0.93, 1.44)	1.19 (1, 1.47)	1.035 (0.86, 1.29)	0.016
Total cholesterol, median (IQR)	4.44 (3.76, 5.07)	4.65 (4.04, 5.28)	4.33 (3.72, 4.85)	0.189
Blood glucose, median (IQR)	4.82 (4.46, 5.13)	4.92 (4.56, 5.25)	4.675 (4.44, 4.97)	0.060
RT dose, median (IQR)	60 (60, 60)	60 (56, 60)	60 (60, 60)	0.561
BMI				< 0.001
< 18.5 kg/m2	7 (6.7)	0 (0)	7 (6.7)
18.5-24.0 kg/m2	70 (66.7)	35 (33.3)	35 (33.3)
≥ 24.0 kg/m2	28 (26.7)	22 (21)	6 (5.7)

NMM: Normal muscle mass; LMM: Low muscle mass; IQR: Interquartile range; WBC: White blood cell count; HGB: Hemoglobin; PLT: Platelet count; NC: Neutrophil count; LC: Lymphocyte count; MC: Monocyte count; ALB: Albumin; PA: Prealbumin; RT: Radiotherapy; BMI: Body mass index; TNM: Tumor-node-metastasis.

Table 2 Univariate and multivariate Cox regression analyses of factors associated with progression-free survival

Characteristics	Total (n)	Univariate analysis		Multivariate analysis
		HR (95%CI)	P value	HR (95%CI)	P value
Sex	105	-	-	-	-
Female	18	Reference	-	-	-
Male	87	1.953 (0.765-4.988)	0.162	-	-
Age	105	1.017 (0.973-1.062)	0.452	-	-
Smoking history	105	-	-	-	-
No	34	Reference	-	-	-
Yes	71	1.015 (0.545-1.890)	0.964	-	-
Alcohol history	105	-	-	-	-
No	38	Reference	-	-	-
Yes	67	0.865 (0.473-1.583)	0.639	-	-
Tumor location	105	-	-	-	-
Cervical	15	Reference	-	-	-
Upper thoracic	26	2.716 (0.870-8.481)	0.086	-	-
Middle thoracic	43	2.540 (0.865-7.456)	0.090	-	-
Lower thoracic	21	2.207 (0.677-7.195)	0.189	-	-
TNM	105	-	-	-	-
III	82	Reference	-	-	-
IV	23	1.690 (0.885-3.226)	0.112	-	-
Triglycerides	105	1.091 (0.725-1.642)	0.676	-	-
Total cholesterol	105	1.163 (0.867-1.559)	0.313	-	-
Blood glucose	105	0.960 (0.748-1.232)	0.748	-	-
HGB	105	1.007 (0.987-1.026)	0.504	-	-
ALB	105	1.030 (0.940-1.128)	0.524	-	-
PA	105	0.999 (0.993-1.005)	0.793	-	-
RT dose	105	0.961 (0.907-1.018)	0.178	-	-
SMI-BMI	105	-	-	-	-
LMM and low BMI	35	Reference	-	Reference	-
NMM and high BMI	41	0.316 (0.147-0.678)	0.0031	0.316 (0.147-0.678)	0.0031
LMM and high BMI	13	1.272 (0.557-2.902)	0.568	1.272 (0.557-2.902)	0.568
NMM and low BMI	16	0.431 (0.173-1.071)	0.070	0.431 (0.173-1.071)	0.070

¹Statistically significant P values.

HR: Hazard ratio; CI: Confidence interval; NMM: Normal muscle mass; LMM: Low muscle mass; HGB: Hemoglobin; ALB: Albumin; PA: Prealbumin; RT: Radiotherapy; SMI: Skeletal muscle index; BMI: Body mass index; TNM: Tumor-node-metastasis.

Table 3 Univariate and multivariate Cox regression analyses of factors associated with overall survival

Characteristics	Total (n)	Univariate analysis		Multivariate analysis
		HR (95%CI)	P value	HR (95%CI)	P value
Sex	105	-	-	-	-
Female	18	Reference	-	Reference	-
Male	87	2.179 (0.852-5.572)	0.104	1.330 (0.474-3.733)	0.589
Age	105	1.015 (0.972-1.060)	0.497	-	-
Smoking history	105	-	-	-	-
No	34	Reference	-	-	-
Yes	71	1.024 (0.550-1.907)	0.939	-	-
Alcohol history	105	-	-	-	-
No	38	Reference	-	-	-
Yes	67	0.921 (0.502-1.688)	0.790	-	-
Tumor location	105	-	-	-	-
Cervical	15	Reference	-	-	-
Upper thoracic	26	2.618 (0.838-8.179)	0.098	-	-
Middle thoracic	43	2.427 (0.828-7.114)	0.106	-	-
Lower thoracic	21	2.152 (0.661-7.004)	0.203	-	-
TNM	105	-	-	-	-
III	82	Reference	-	-	-
IV	23	1.473 (0.770-2.817)	0.242	-	-
Triglycerides	105	1.013 (0.670-1.531)	0.951	-	-
Total cholesterol	105	1.164 (0.862-1.572)	0.321	-	-
Blood glucose	105	0.979 (0.767-1.251)	0.866	-	-
HGB	105	1.006 (0.987-1.026)	0.515	-	-
ALB	105	1.008 (0.921-1.103)	0.865	-	-
PA	105	0.999 (0.993-1.005)	0.649	-	-
RT dose	105	0.953 (0.902-1.007)	0.087	0.935 (0.877-0.997)	0.0391
SMI-BMI	105	-	-
LMM and low BMI	35	Reference	-	Reference
NMM and high BMI	41	0.259 (0.119-0.562)	< 0.0011	0.265 (0.119-0.588)	0.0011
LMM and high BMI	13	1.088 (0.477-2.482)	0.841	1.030 (0.450-2.358)	0.944
NMM and low BMI	16	0.426 (0.172-1.053)	0.064	0.327 (0.116-0.925)	0.0351

¹Statistically significant P values.

HR: Hazard ratio; CI: Confidence interval; NMM: Normal muscle mass; LMM: Low muscle mass; HGB: Hemoglobin; ALB: Albumin; PA: Prealbumin; RT: Radiotherapy; SMI: Skeletal muscle index; BMI: Body mass index; TNM: Tumor-node-metastasis.