A Retrospective Cohort Study of Myosteatosis and Quality of Life in Head and Neck Cancer Patients

Shaver, Amy L.; Noyes, Katia; Ochs‐Balcom, Heather M.; Wilding, Gregory E.; Ray, Andrew D.; Jun, Sung; Farrugia, Mark; Singh, Anurag; Platek, Mary E.

doi:10.3390/cancers13174283

Cited by 4 publications

(3 citation statements)

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“… 46 Further complicating matters, studies have suggested that BMI alone may not be representative of one’s body fat composition and cachexia. 47 , 48 Another quantitative measure correlated with BMI is skeletal muscle depletion measured based on CT imaging, which has been shown to be associated with worse survival 24 , 49 and quality of life 50 among patients with head and neck cancer.…”

Section: Discussionmentioning

confidence: 99%

Association of Body Mass Index With Outcomes Among Patients With Head and Neck Cancer Treated With Chemoradiotherapy

et al. 2023

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ImportanceCombined modality therapy, such as chemoradiotherapy, often results in significant morbidity among patients with head and neck cancer. Although the role of body mass index (BMI) varies based on cancer subtypes, its association with treatment response, tumor recurrence, and survival outcomes among patients with head and neck cancer remains unclear.ObjectiveTo evaluate the role of BMI in treatment response, tumor recurrence, and survival outcomes among patients with head and neck cancer undergoing chemoradiotherapy.Design, Setting, and ParticipantsThis retrospective, observational, single-institution cohort study conducted at a comprehensive cancer center included 445 patients with nonmetastatic head and neck cancer who underwent chemoradiotherapy from January 1, 2005, to January 31, 2021.ExposureNormal vs overweight or obese BMI.Main Outcomes and MeasuresMetabolic response after chemoradiotherapy, locoregional failure (LRF), distant failure (DF), overall survival (OS), and progression-free survival (PFS), with Bonferroni correction used to adjust for multiple comparisons and P &lt; .025 being considered statistically significant.ResultsA total of 445 patients (373 men [83.8%]; median age, 61 years [IQR, 55-66 years]; 107 [24.0%] with normal BMI, 179 [40.2%] with overweight BMI, and 159 [35.7%] with obese BMI) were included for analysis. Median follow-up was 48.1 months (IQR, 24.7-74.9 months). On Cox proportional hazards regression multivariable analysis, only overweight BMI was associated with improved OS (5-year OS, 71.5% vs 58.4%; adjusted hazard ratio [AHR], 0.59 [95% CI, 0.39-0.91]; P = .02) and PFS (5-year PFS, 68.3% vs 50.8%; AHR, 0.51 [95% CI, 0.34-0.75]; P &lt; .001). On logistic multivariable analysis, overweight BMI (91.6% vs 73.8%; adjusted odds ratio [AOR], 0.86 [95% CI, 0.80-0.93]; P &lt; .001) and obese BMI (90.6% vs 73.8%; AOR, 0.89 [95% CI, 0.81-0.96]; P = .005) were associated with complete metabolic response on follow-up positron emission tomography–computed tomography after treatments. On Fine-Gray multivariable analysis, overweight BMI was associated with reduction in LRF (5-year LRF, 7.0% vs 25.9%; AHR, 0.30 [95% CI, 0.12-0.71]; P = .01), but not DF (5-year DF, 17.4% vs 21.5%; AHR, 0.92 [95% CI, 0.47-1.77]; P = .79). Obese BMI was not associated with LRF (5-year LRF, 10.4% vs 25.9%; AHR, 0.63 [95% CI, 0.29-1.37]; P = .24) or DF (5-year DF, 15.0% vs 21.5%; AHR, 0.70 [95% CI, 0.35-1.38]; P = .30).ConclusionIn this cohort study of patients with head and neck cancer, when compared with normal BMI, overweight BMI was an independent factor favorably associated with complete response after treatments, OS, PFS, and LRF. Further investigations are warranted to improve understanding on the role of BMI among patients with head and neck cancer.

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Section: Discussionmentioning

confidence: 99%

Association of Body Mass Index With Outcomes Among Patients With Head and Neck Cancer Treated With Chemoradiotherapy

et al. 2023

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“…However, decreased SMRA has been described as a feature of advanced cancers and associated with poorer muscle function and shorter overall survival in various cancer populations [16,19,41]. Shaver et al linked myosteatosis to decreased quality of life in HNC patients one year after treatment completion [42].…”

Section: Discussionmentioning

confidence: 99%

Preoperative CT-Based Skeletal Muscle Mass Depletion and Outcomes after Total Laryngectomy

Salati

Mandralis

Becce

et al. 2023

Cancers

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Purpose: To assess the role of preoperative CT-based skeletal muscle mass depletion on postoperative clinical outcomes and survival in patients who underwent total laryngectomy for cancer. Methods: Patients operated on between January 2011 and March 2020 were retrospectively included. Skeletal muscle area and intra- and inter-muscular fat accumulation were measured at the third lumbar vertebral level on preoperative CT scans. Skeletal muscle mass depletion was defined based on pre-established cut-off values. Their association with postoperative morbidity, length of stay (LOS), costs, and survival was assessed. Results: A total of 84 patients were included, of which 37 (44%) had preoperative skeletal muscle mass depletion. The rate of postoperative fistula (23% vs. 35%, p = 0.348), cutaneous cervical dehiscence (17% vs. 11%, p = 0.629), superficial incisional surgical site infections (SSI) (12% vs. 10%, p = 1.000), and unplanned reoperation (38% vs. 37%, p = 1.000) were comparable between the two patient groups. No difference in median LOS was observed (41 vs. 33 days, p = 0.295), nor in treatment costs (119,976 vs. 109,402 CHF, p = 0.585). The median overall survival was comparable between the two groups (3.43 vs. 4.95 years, p = 0.09). Conclusions: Skeletal muscle mass depletion alone had no significant impact on postoperative clinical outcomes or survival.

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“…A mioesteatose (infiltração de gordura no músculo) está diretamente ligada a piores desfechos clínicos e menor sobrevida, devido a diminuição da qualidade do músculo e sua função, e pode ser vista tanto em pacientes com doenças catabólicas como o câncer, quanto no processo do envelhecimento (MARTIN et al, 2013;PRADO et al, 2008;SHAVER et al, 2021) SANTANA, 2005;DICKERSON, 2005). O hipercatabolismo está associado à menor sobrevida, pois leva à perda de massa magra e de gordura, além de contribuir com o processo inflamatório (FIACCADORI et al, 2013;KREYMANN et al, 2012).…”

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Suplementação de leucina em pacientes com câncer de cabeça e pescoço: efeitos na composição corporal e sobre parâmetros inflamatórios.

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Agradeço a Deus por ter me acompanhado nessa longa jornada e ter me dado forças para continuar sempre. Não foi um caminho fácil, mas com certeza um caminho que valeu muito a pena. Agradeço ao meu Universo pelas energias, pela serenidade, por me fazer ver o mundo de uma cor que eu não conhecia, mas que jamais deixarei de enxergar agora.À minha família por me suportarem, literalmente, e me apoiarem neste período de introspecção e afastamento. Especialmente ao meu marido, Nelson Malagoli, por todo o apoio incondicional, incentivo, pelo companheirismo, por toda compreensão e por cuidar das nossas filhas enquanto eu estava ausente. E claro, às minhas filhas por me perdoarem por todas as vezes em que não pude estar fisicamente com elas.À minha orientadora, Profa. Dra. Marília Seelaender, pela oportunidade de fazer parte deste grupo incrível, por todo conhecimento que adquiri e por toda a vivência proporcionada. Pela visão técnica e crítica que só me fizeram amadurecer como pessoa e como profissional. E à minha coorientadora e professora desde a faculdade Dra. Daniela Caetano, sempre disposta a ajudar, obrigada pela paciência.Aos meus colegas de laboratório, por todo ensinamento que tive de cada um, pela paciência em me ensinarem os processos da vida acadêmica. Em especial à minha querida amiga Ivanir Pires, por todo o suporte, por todas as conversas, por todas as vezes que estava ali do meu lado me ajudando e guiando, eu não teria conseguido sem seu apoio. E ao meu amigo Sílvio, obrigada pelos cafés e chocolates (que me deve), pelo apoio e suporte e por tornar esse caminho mais suave.Agradeço em particular Gabriela Salim pelos ensinamentos, apoio e nossas longas discussões de última hora, sempre contribuindo para o meu crescimento.Minha amiga Jaline, por estar sempre pronta a me auxiliar. Meus sinceros agradecimentos.À toda equipe de colaboradores externos dos hospitais ICAVC e HU. Aos pacientes que contribuíram diretamente para este projeto, obrigada pela confiança. Muitos agradecimentos à Rosana Prisco que teve toda a paciência do mundo em me auxiliar na estatística e por estar sempre pronta a ajudar. O presente trabalho foi realizado com apoio da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior -Brasil (CAPES), 2022. Sob código de financiamento -Processo: 88882.377348/2019-01. A mente que se abre a uma nova ideia jamais voltará ao seu tamanho original. (Albert Einstein) RESUMO Santos, MFA. Suplementação de leucina em pacientes com câncer de cabeça e pescoço: efeitos na composição corporal e sobre parâmetros inflamatórios. 2022. (100 folhas).

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A Retrospective Cohort Study of Myosteatosis and Quality of Life in Head and Neck Cancer Patients

Cited by 4 publications

References 40 publications

Association of Body Mass Index With Outcomes Among Patients With Head and Neck Cancer Treated With Chemoradiotherapy

Association of Body Mass Index With Outcomes Among Patients With Head and Neck Cancer Treated With Chemoradiotherapy

Preoperative CT-Based Skeletal Muscle Mass Depletion and Outcomes after Total Laryngectomy

Suplementação de leucina em pacientes com câncer de cabeça e pescoço: efeitos na composição corporal e sobre parâmetros inflamatórios.

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