Srpčič M. Letter to the Editor: Clinical consequences of body composition disturbances. World J Clin Oncol 2026; 17(6): 120121 [DOI: 10.5306/wjco.120121]
Corresponding Author of This Article
Matevž Srpčič, PhD, Assistant Professor, Consultant, Department of Thoracic Surgery, University Medical Centre Ljubljana, Zaloška cesta 2, Ljubljana 1000, Slovenia. matevz.srpcic@kclj.si
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Oncology
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letter
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Srpčič M. Letter to the Editor: Clinical consequences of body composition disturbances. World J Clin Oncol 2026; 17(6): 120121 [DOI: 10.5306/wjco.120121]
World J Clin Oncol. Jun 24, 2026; 17(6): 120121 Published online Jun 24, 2026. doi: 10.5306/wjco.120121
Letter to the Editor: Clinical consequences of body composition disturbances
Matevž Srpčič
Matevž Srpčič, Department of Thoracic Surgery, University Medical Centre Ljubljana, Zaloška cesta 2, Ljubljana 1000, Slovenia
Matevž Srpčič, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, Ljubljana 1000, Slovenia
Author contributions: Srpčič M wrote the manuscript and submitted it for publication.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Corresponding author: Matevž Srpčič, PhD, Assistant Professor, Consultant, Department of Thoracic Surgery, University Medical Centre Ljubljana, Zaloška cesta 2, Ljubljana 1000, Slovenia. matevz.srpcic@kclj.si
Received: February 24, 2026 Revised: April 18, 2026 Accepted: June 1, 2026 Published online: June 24, 2026 Processing time: 127 Days and 13.7 Hours
Abstract
I read with interest the retrospective cohort study by Xiao et al entitled “Body mass index predicts low muscle mass in esophageal squamous cell carcinoma patients undergoing chemoradiotherapy”. Body composition (BC) assessment is becoming an indispensable tool in clinical care. It provides data on patients’ nutritional and functional characteristics, helping clinicians determine prognosis and risk factors when planning treatment. Muscle loss is an independent negative prognostic factor in esophageal cancer. It has been associated with worse overall survival, worse quality of life and with increased incidence of complications during both surgical treatment and radical chemoradiotherapy. Recognizing patients with increased risk enables therapists to adjust treatment regimens and optimize nutritional support. Methods for evaluating BC have evolved rapidly in the last two decades. Traditional readily available measures such as body mass index and other anthropometrics are supplemented with advanced BC analysis techniques including planimetry (computed tomography or magnetic resonance imaging based BC scans), bioimpedance and emerging ultrasound BC analysis techniques. The pitfalls of misinterpreting body mass index in special scenarios such as sarcopenic obesity must be kept in mind as well as the intricate interplay between body mass, BC and their effects on outcomes. The obesity paradox needs further investigating focusing particularly on body mass, fat free body mass and muscle mass as measures of the actual functional reserve.
Core Tip: Body composition analysis is indispensable in modern comprehensive cancer care, especially so in esophageal cancer. Traditional indicators of depletion of body reserves such as weight loss and body mass index remain useful to some extent and in certain populations but direct assessment of muscle mass, muscle quality and adipose tissue mass offers better sensitivity and specificity especially in the normal and overweight body mass index groups.
