Impact of sarcopenia in locally advanced head and neck cancer treated with chemoradiation: An Indian tertiary care hospital experience

Nagpal, Puneet; Pruthi, Deep Shankar; Pandey, Manish; Yadav, Ashu; Singh, Harpreet

doi:10.1016/j.oraloncology.2021.105483

Cited by 24 publications

(13 citation statements)

References 28 publications

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“…Comparable associations for disease-specific survival (DSS) were found in 5 studies for patients treated by surgery (HR 2.96, 95% CI: 0.73–11.95) and radiotherapy (HR 2.67, 95% CI: 1.51–4.73) [51]. These results were confirmed in more recent studies [28,52,53].…”

Section: Survivalmentioning

confidence: 70%

“…Although patients with low SMM did not have a decreased OS, patients who experienced DLT did have a significantly decreased OS (HR 2.11) [27]. In 300 HNC patients treated with definitive chemoradiotherapy, patients with low SMI were more likely to experience moderate to severe toxicities and more treatment gaps [28]. In 82 naso-pharyngeal cancer patients treated by concurrent platin-based chemoradiotherapy, low SMM (91%) was associated with DLT defined as the need to reduce the drug dose, to delay, or definitively to discontinue the protocol (OR 4.00, 95% CI: 1.20-13.36) [29].…”

Section: Toxicity Of Anti-cancer Drugsmentioning

confidence: 96%

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Sarcopenia and its impact in head and neck cancer treatment

Bree

Beers

Schaeffers

2022

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of reviewThe aim of this review is to discuss recent studies on the assessment of sarcopenia and its predictive and prognostic value in head and neck cancer (HNC) patients. Recent findingsThere is increasing evidence that low skeletal muscle mass (SMM), often named sarcopenia, can easily be assessed on cross-sectional imaging of the head and neck and is associated with chemotherapy (dose limiting) and radiotherapy toxicity and survival. SummarySMM measurement at the level of the third cervical vertebra (C3) on routine computed tomography and magnetic resonance imaging is easy and robust to perform. Several studies have shown a significantly higher incidence of cisplatin dose limiting toxicity in HNC patients with a low SMM. In HNC patients pretreatment low SMM is associated with acute and late toxicity and adverse events of radiotherapy, complications of major head and neck surgery and decreased disease-specific and overall survival. This information can be used for individualized treatment planning in HNC patients with low SMM.

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Section: Survivalmentioning

confidence: 70%

Section: Toxicity Of Anti-cancer Drugsmentioning

confidence: 96%

Sarcopenia and its impact in head and neck cancer treatment

Bree

Beers

Schaeffers

2022

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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“…Cachexia is associated with inadequate food intake, metabolic derangement, inactivity, loss of muscle mass, and weight loss in patients with advanced malignant tumors ( 17 ). More toxicities, treatment gaps, and postoperative complications as well as poorer disease-free survival are generally contributed by cachexia ( 19 ). Fukuta et al.…”

Section: Discussionmentioning

confidence: 99%

Predictors predisposing to orocutaneous fistula occurrence following free flap reconstruction

Yuan

et al. 2022

Front. Oncol.

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ObjectivesTo explore the possible risk factors of orocutaneous fistula (OCF) development in free flap reconstruction of the tongue/floor of the mouth (TFOM).MethodsData of patients who underwent free flap reconstruction of the TFOM were retrospectively analyzed. The association between clinicopathologic variables and OCF occurrence was analyzed using univariate and multivariate analyses.ResultsAltogether, 469 patients were enrolled. OCF occurred in 43 patients with a rate of 9.2%. The univariate analysis revealed the negative effects of smoking, preoperative albumin level, cachexia, T4 stage, neck dissection, entire resection of the floor of the mouth (FOM), segmental mandibulectomy, and surgical site infection on OCF occurrence. The multivariate analysis confirmed the independence of cachexia (p<0.001, 4.386[1.883–9.472]), tumor stage (p<0.001, 2.738[1.482–6.629]), entire FOM resection (p<0.001, 6.332[2.110–14.432]), and surgical site infection (p<0.001, 5.376[1.998–11.218]) in affecting the OCF development.ConclusionsOCF development following free flap reconstruction of the TFOM was relatively uncommon, but significantly associated with presence of cachexia, T4 stage, entire FOM resection, and surgical site infection.

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“…Cachexia is related to weight loss, inadequate food intake, inactivity, loss of muscle mass, and metabolic derangement in patients with advanced cancer ( 16 ). It could result in more toxicities, poorer disease-free survival, and more treatment gaps ( 20 ). More importantly, postoperative complications are associated with cachexia.…”

Section: Discussionmentioning

confidence: 99%

Orocutaneous Fistula Formation in Free Flap Reconstruction for Oral Squamous Cell Carcinoma

Fang

Yuan

et al. 2022

Front. Oncol.

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ObjectiveThe aim of this study is to identify the risk factors associated with orocutaneous fistula (OCF) formation after free flap reconstruction for oral squamous cell carcinoma (SCC).MethodsPatients undergoing free flap reconstruction for oral SCC were retrospectively enrolled. The relationship between clinicopathologic variables and OCF formation was analyzed by univariate and multivariate analyses.ResultsA total of 87 OCFs occurred in 856 patients. Univariate analysis revealed cachexia, tumor at the tongue/floor of the mouth (TFOM), T4 stage, preoperative hemoglobin level, pull-through procedure, preoperative albumin level, and surgical site infection were associated with the formation of OCF. Multivariate analysis confirmed the independence of cachexia, TFOM, T4 stage, and surgical site infection in predicting OCF development. Conventional wound care could achieve successful fistula closure in 82.4% of the patients with a median time of 28 days.ConclusionsOCF formation was common after free flap reconstruction. The presence of cachexia, TFOM tumor site, T4 stage, and surgical site infection significantly increased the risk of OCF formation. Although it required a long period, conventional wound care can obtain satisfactory outcomes in OCF management.

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Impact of sarcopenia in locally advanced head and neck cancer treated with chemoradiation: An Indian tertiary care hospital experience

Cited by 24 publications

References 28 publications

Sarcopenia and its impact in head and neck cancer treatment

Sarcopenia and its impact in head and neck cancer treatment

Predictors predisposing to orocutaneous fistula occurrence following free flap reconstruction

Orocutaneous Fistula Formation in Free Flap Reconstruction for Oral Squamous Cell Carcinoma

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