Impact of Preoperative Low Prognostic Nutritional Index and High Intramuscular Adipose Tissue Content on Outcomes of Patients with Oral Squamous Cell Carcinoma

Abstract

The impact of preoperative malnutrition and sarcopenia on survival in oral squamous cell carcinoma (OSCC) patients remains controversial. We investigated the effects of the preoperative nutritional status and abnormalities in body composition on the mortality of OSCC patients. A retrospective study involving 103 patients with OSCC was conducted. Disease-specific survival (DSS) according to the preoperative psoas muscle mass index (PMI) and intramuscular adipose tissue content (IMAC) was evaluated. Univariate and multivariate analyses were performed to determine the predictive performance of the covariates with respect to DSS. The DSS rate in patients with high IMAC and low PMI was significantly lower than that in controls. Multivariate analysis revealed that a low preoperative Prognostic Nutritional Index (PNI) and high IMAC were independent risk factors. We demonstrated that preoperative malnutrition and abnormal body composition, such as preoperative skeletal muscle quality, are associated with DSS in OSCC patients. Our study suggests that the evaluation of preoperative malnutrition and skeletal muscle quality would be useful for predicting mortality in patients with OSCC.

Prognostic Role of Preoperative Sarcopenia Evaluation of Cervical Muscles with Long-Term Outcomes of Patients with Oral Squamous Cell Carcinoma

“…There are several ways to measure muscle quantity. Namely, cross-sectional area of a specific muscle group or body part, total body skeletal muscle mass, or appendicular skeletal muscle mass, although there is still debate as to which method is superior [ 13 ]. On the other hand, it has been reported that measurement of the psoas muscle at the L3 level using CT for assessing muscle quantity is useful in predicting morbidity in a variety of conditions [ 16 ].…”

“…On the other hand, since the psoas area estimates both muscle and intramuscular adipose tissue, PMI does not always indicate actual muscle mass because the areas of psoas muscles evaluate both muscle and intramuscular adipose tissue [ 23 ]. In our previous study, OSCC patients with preoperative low muscle quantity as defined by low PMI and low muscle quality as defined by high IMAC had significantly lower disease-specific survival than controls [ 13 ]. These results suggest that there is a substantial interaction between the preoperative comorbidity of sarcopenia and the mortality of patients with OSCC.…”

“…In our previous study, we compared preoperative lumbar skeletal muscle mass at the L3 level with skeletal muscle adiposity using preoperative CT images of patients with OSCC [ 13 ]. In this study, it was reported that patients with preoperative lumbar skeletal muscle mass loss (loss of skeletal muscle quantity) and skeletal muscle adiposity (loss of skeletal muscle quality) had significantly lower disease-specific survival rates compared to controls.…”

“…In this study, it was reported that patients with preoperative lumbar skeletal muscle mass loss (loss of skeletal muscle quantity) and skeletal muscle adiposity (loss of skeletal muscle quality) had significantly lower disease-specific survival rates compared to controls. These results indicate that sarcopenia assessment from preoperative CT can be useful in predicting the prognosis of patients with OSCC [ 13 ].…”

Masticatory muscle index for indicating skeletal muscle mass in patients with head and neck cancer

“…Our study also has therapeutic implications. Regular dietary counseling and nutritional intervention might help patients with HNC who are at nutritional risk or have low M-SMI to minimize muscle atrophy, maintain their body weight, and prevent severe malnutrition, thereby improving their survival outcomes and quality of life [31][32][33].…”