CT-based assessment of myosteatosis as an indicator of surgical outcomes in esophagogastric cancer: a systematic review
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By
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Goran Rondovic
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Momir Sarac
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Ivan Lekovic
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Nebojsa Maric
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Sanja Sarac
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Dusica Stamenkovic
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Maja Stojanovic
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Suzana Bojic
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July 21, 2026
Clinical Scorecard: CT-based assessment of myosteatosis as an indicator of surgical outcomes in esophagogastric cancer: a systematic review
At a Glance
| Category | Detail |
|---|
| Condition | Myosteatosis in esophagogastric cancer surgery |
| Key Mechanisms | Impaired skeletal muscle quality and fatty muscle infiltration |
| Target Population | Adult patients undergoing elective surgery for esophageal or gastric malignancies |
| Care Setting | Oncologic surgery |
Key Highlights
- Myosteatosis is associated with major postoperative complications (Clavien–Dindo ≥ III).
- Effect sizes for myosteatosis range from approximately 2 to 5 across multiple cohorts.
- Muscle quality may provide stronger prognostic associations than muscle quantity alone.
- Composite body composition measures show improved predictive performance.
- Methodological heterogeneity limits comparability between studies.
Guideline-Based Recommendations
Diagnosis
- Evaluate CT-derived muscle quality parameters preoperatively.
Management
- Consider myosteatosis as a marker for risk stratification in surgical planning.
Monitoring & Follow-up
- Monitor postoperative outcomes including complications and length of stay.
Risks
- Increased risk of major postoperative morbidity associated with myosteatosis.
Patient & Prescribing Data
Adult patients undergoing elective surgery for esophageal or gastric malignancies.
Myosteatosis assessment may inform perioperative management strategies.
Clinical Best Practices
- Standardize muscle quality assessment methods in clinical practice.
- Utilize CT for opportunistic assessment of muscle quality during cancer staging.
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