Evaluation of Sarcopenia, Frailty, and Inflammation on Adverse Events and Survival Outcomes in Patients with Oral Cavity Squamous Cell Carcinoma under Adjuvant Chemoradiotherapy

Huang, Chun-Hou; Chen, Peir-Rorg; Lue, Kun-Han; Hsieh, Tsung-Cheng; Chou, Yu-Fu

doi:10.3390/jpm11090936

Cited by 8 publications

(2 citation statements)

References 47 publications

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“…In our previous retrospective studies, 56 , 57 we used a regular head and neck computed tomography slice at the level of the third cervical vertebra to measure skeletal muscle mass and to calculate the SMI. Significant association was found between sarcopenia and curative treatment-related toxicities and survival.…”

Section: Discussionmentioning

confidence: 99%

Investigating sarcopenia, physical activity, and inflammation biomarkers in newly diagnosed oral cancer patients undergoing curative treatment: A prospective longitudinal study

Huang¹,

Peng²,

Chou³

et al. 2023

Asia-Pacific Journal of Oncology Nursing

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Section: Discussionmentioning

confidence: 99%

Investigating sarcopenia, physical activity, and inflammation biomarkers in newly diagnosed oral cancer patients undergoing curative treatment: A prospective longitudinal study

Huang¹,

Peng²,

Chou³

et al. 2023

Asia-Pacific Journal of Oncology Nursing

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“…Identifying the elderly cancer patients at higher risks of adverse treatment outcomes and mortality is a clinical priority. Two novel clinical prognostic indicators receiving increasing attention across different cancer types include frailty and elevated neutrophil-to-lymphocyte ratio (NLR, a marker of systemic inflammation) ( 1 ). Frailty is a state of vulnerability, and it is recognized as a strong predictor of adverse clinical outcomes ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Effects of systemic inflammation and frailty on survival in elderly cancer patients: Results from the INSCOC study

et al. 2023

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BackgroundFrailty and systemic inflammation are parameters, which are easy to evaluate, can be used to predict disease outcomes, and are potentially modifiable. The combination of frailty and inflammation-based data may help identify elderly cancer patients predisposed to adverse clinical outcomes. The aim of this study was to examine the association of systemic inflammation and frailty at admission, and to determine whether these risk factors interact and may predict the survival of elderly cancer patients.MethodsA prospective Investigation on Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) with 5,106 elderly cancer patients admitted from 2013 through 2020 was included in this study. The primary marker of inflammation was the neutrophil-to-lymphocyte ratio (NLR), with the reference group having NLR<3, which indicated no inflammation. Frailty was assessed using the FRAIL scale, and patients with≥3 positives out of a total of five components were assumed to be frail. The primary outcome was all-cause mortality. We classified participants according to the presence (or absence) of frailty and high inflammation and assessed their association with overall survival using the Cox proportional hazards models adjusted for demographic, tumor, and treatment factors.ResultsAmong the 5,106 patients enrolled in the study, 3396 individuals (66.51%) were male and the mean( ± SD) age at diagnosis was 70.92( ± 5.34). Over a median of 33.5 months follow-up, we observed 2,315 deaths. Increasing NLR was associated with frailty (compared with NLR<3, odds ratio=1.23, 95%CI=1.08-1.41 for NLR≥3). An NLR≥3 and frailty independently predicted the overall survival [hazard ratio(HR)=1.35, 95%CI=1.24-1.47 and HR=1.38, 95%CI=1.25-1.52, respectively). Patients with both frailty and NLR≥3 had the lowest overall survival(HR=1.83, 95%CI=1.59-2.04) than patients with no risk factors. The mortality rate increased with the presence of the frailty components.ConclusionsSystemic inflammation was positively associated with frailty. Frail elderly cancer patients with elevated systemic inflammation had low survival rate.

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Sarcopenia Is a Prognostic Factor of Adverse Effects and Mortality in Patients With Tumour: A Systematic Review and Meta‐Analysis

Zhang,

Zhan

et al. 2024

J cachexia sarcopenia muscle

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BackgroundThe relationship between sarcopenia and the prognosis of patients with tumours who received radio‐ and/or chemotherapy still needs to be determined. In this study, we aim to investigate the relationship between sarcopenia and adverse effects and mortality in patients with tumours that received radio‐ and/or chemotherapy, stratified by study design, tumour category, the method sarcopenia assessed, treatment options, study location and among other factors.MethodsPubMed, Web of Science and Embase were searched from inception to 15 August 2024, without language restrictions and with a manual search of references for additional articles retrieval. Cohort studies of ≥ 100 patients with tumours that evaluated the association between sarcopenia or muscle mass and the adverse effects or overall survival induced by radio‐ and/or chemotherapy were included.ResultsThirty‐nine studies were included, involving 8966 patients with tumours, including 3383 patients with sarcopenia. The pooled prevalence of sarcopenia in patients with tumours was 0.42 (95% CI 0.36–0.48, p < 0.001) overall. The prevalence of sarcopenia is higher in Oceania patients 0.60 (95% CI 0.28–0.89, p < 0.001), those with reproductive tumour 0.57 (95% CI 0.30–0.83, p < 0.001), and sarcopenia assessed by the lumbar‐skeletal muscle index 0.46 (95% CI 0.39–0.53, p < 0.001) than in other subgroups, but not show significant differences in sex. Sarcopenia was associated with an increased risk of adverse effects in patients who received radio‐ and/or chemotherapy, with a relative risk (RR) of 1.44 (95% CI 1.21–1.71, p < 0.001). Retrospective studies (RR = 1.49; 95% CI 1.24–1.79; p < 0.001), sarcopenia assessed by other methods (RR = 2.98; 95% CI 1.52–5.87; p < 0.001), and patients in Europe (RR = 1.92; 95% CI 1.15–3.22; p = 0.013), received chemoradiotherapy (RR = 1.47; 95% CI 1.23–1.76; p < 0.001), and with head and neck tumours (RR = 1.54; 95% CI 1.17–2.01; p = 0.010) had higher relative risk than other subgroups. Sarcopenia was also associated with reduced overall survival in patients with tumours, with a pooled hazard ratio (HR) of 1.66 (95% CI 1.40–1.96, p < 0.001). Prospective studies (HR = 1.72; 95% CI 0.97–3.07; p = 0.065), sarcopenia assessed by the cervical‐skeletal muscle index (HR = 2.66; 95% CI 1.73–4.09; p < 0.001), and patients in Asia (HR = 1.91; 95% CI 1.50–2.42; p < 0.001), received chemoradiotherapy (HR = 1.85; 95% CI 1.46–2.45; p < 0.001) and with head and neck tumours (HR = 2.35; 95% CI 1.88–2.95; p < 0.001) had higher HR than other subgroups.ConclusionsSarcopenia was associated with a higher risk of adverse effects and mortality in patients with tumours received radio‐ and/or chemotherapy.

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Evaluation of Sarcopenia, Frailty, and Inflammation on Adverse Events and Survival Outcomes in Patients with Oral Cavity Squamous Cell Carcinoma under Adjuvant Chemoradiotherapy

Cited by 8 publications

References 47 publications

Investigating sarcopenia, physical activity, and inflammation biomarkers in newly diagnosed oral cancer patients undergoing curative treatment: A prospective longitudinal study

Investigating sarcopenia, physical activity, and inflammation biomarkers in newly diagnosed oral cancer patients undergoing curative treatment: A prospective longitudinal study

Effects of systemic inflammation and frailty on survival in elderly cancer patients: Results from the INSCOC study

Sarcopenia Is a Prognostic Factor of Adverse Effects and Mortality in Patients With Tumour: A Systematic Review and Meta‐Analysis

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