Low skeletal muscle mass as predictor of postoperative complications and decreased overall survival in locally advanced head and neck squamous cell carcinoma: the role of ultrasound of rectus femoris muscle

Galli, Andrea; Colombo, Michele; Carrara, Giulia; Luce, Francesca Lira; Paesano, Pier Luigi; Giordano, Leone; Bondi, Stefano; Tulli, Michele; Mirabile, Aurora; Cobelli, Francesco De; Bussi, Mario

doi:10.1007/s00405-020-06123-3

Cited by 22 publications

(35 citation statements)

References 42 publications

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“…A study by Bril et al [17] demonstrated postoperative mortality of 3.7% in patients with sarcopenia, in contrast to 0% in patients without sarcopenia. Similarly, Galli et al [45] reported a thirty-day postoperative mortality rate of 22.2% in the sarcopenia group and 0% in the non-sarcopenia group, in which half of the deaths within 30 days were due to sepsis resulting from pharyngocutaneous fistula or aspiration pneumonitis, and the other half were caused by cardiac events. Thus, postoperative infections and complications from perioperative stress in surgically treated patients with sarcopenia result in higher mortality.…”

Section: Plos Onementioning

confidence: 84%

Prognostic impact of sarcopenia in patients with head and neck cancer treated with surgery or radiation: A meta-analysis

et al. 2021

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Background The objective of this study was to compare the prognostic impact of sarcopenia in patients with head and neck cancer (HNC) treated with surgery or radiation. Methods We systematically searched electronic databases to identify articles reporting the impact of sarcopenia on the prognosis of patients with HNC. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) were extracted and pooled. HR according to treatment modality were estimated using random-effects models. Statistical analyses were carried out using the Comprehensive Meta-Analysis software. Results In total, 18 studies enrolling 3,233 patients were included. Sarcopenia was associated with poor OS in both surgery and radiotherapy groups (hazard ratio [HR] 2.50, 95% confidence interval [CI] 1.95–3.21; HR 1.63, 95% CI 1.40–1.90, respectively). The HR was significantly higher in the surgery group than in the radiotherapy group (p = 0.004), with similar results obtained for DFS (HR 2.59, 95% CI 1.56–4.31; HR 1.56, 95% CI 1.24–1.97 for the surgery and radiotherapy groups, respectively) and DSS (HR 2.96, 95% CI 0.73–11.95; HR 2.67, 95% CI 1.51–4.73 for the surgery and RT groups, respectively). Conclusions Sarcopenia was a poor prognostic factor for HNC, regardless of the treatment modality. However, the adverse effects of sarcopenia on survival were more prominent in the surgery group than in the radiotherapy group. Sarcopenia assessment is required for appropriate treatment decision-making.

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Section: Plos Onementioning

confidence: 84%

Prognostic impact of sarcopenia in patients with head and neck cancer treated with surgery or radiation: A meta-analysis

et al. 2021

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“…Recently, some reports indicated that ultrasound can also be used successfully to estimate skeletal muscle mass. 50 , 51 …”

Section: Discussionmentioning

confidence: 99%

“…Recently, some reports indicated that ultrasound can also be used successfully to estimate skeletal muscle mass. 50,51 Fourth, the adjustment variables in the multiple Cox regression models differed in the considered studies. Unfortunately, in all studies, tumors of different origins were pooled and, therefore, no sub-analyses in regard to tumor site and/or stage could be performed.…”

Section: Discussionmentioning

confidence: 99%

Low skeletal muscle mass predicts relevant clinical outcomes in head and neck squamous cell carcinoma. A meta analysis

Surov

Wienke

2021

Ther Adv Med Oncol

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Background: The purpose of this meta-analysis was to analyze the influence of sarcopenia, defined as low skeletal muscle mass, on clinical outcomes in patients with head and neck squamous cell carcinoma (HNSCC) based on a large sample. Methods: The MEDLINE, EMBASE, and SCOPUS databases were screened for associations between sarcopenia and clinical outcomes in HNSCC up to December 2020. Overall, 27 studies met the inclusion criteria. The methodological quality of the studies involved was checked according to the QUADAS instrument. The meta-analysis was undertaken using RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance weights were used to account for heterogeneity between the studies. Results: The 27 included studies comprised 7704 patients with different HNSCCs. The cumulative calculated frequency among the studies was 42.0% [95% confidence interval (CI) 35.34–48.65]. Sarcopenia was associated with occurrence of severe postoperative complications, odds ratio (OR) 4.79, 95% CI (2.52–9.11), p < 0.00001. Sarcopenia predicted disease-free survival (DFS), simple regression: hazard ratio (HR) 2.00, 95% CI (1.63–2.45), p < 0.00001, multiple regression: HR 1.64, 95% CI (1.33–2.03), p < 0.00001. Also, sarcopenia was associated with lower overall survival (OS), simple regression: HR 1.96, 95% CI (1.71–2.24), p < 0.00001, multiple regression: HR = 1.87, 95% CI (1.53–2.29), p < 0.00001. In patients who underwent definitive chemotherapy and/or radiation, sarcopenia predicted lower OS (simple regression), HR 1.95, 95% CI (1.61–2.36), p < 0.00001, multiple regression: HR = 1.51, 95% CI (1.17–1.94), p < 0.002). In patients with primary surgical strategy with or without adjuvant radio-chemotherapy, sarcopenia was associated with lower OS (simple regression), HR 2.21, 95% CI (1.72–2.84), p < 0.00001, multiple regression: HR = 2.05, 95% CI (1.55–2.72), p < 0.00001). Conclusion: The cumulative prevalence of sarcopenia in HNSCC is 42.0%. Sarcopenia is an independent risk factor for OS and DFS in patients with HNSCC who undergo curative therapy. Sarcopenia is associated with the occurrence of severe postoperative complications.

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“…Generally, 3-methylhistidine is considered a marker of muscle proteolysis; moreover, increased 3-methylhistidine levels could be biomarkers of frailty and sarcopenia ( 27 , 28 ). General statuses, including Karnofsky performance status, sarcopenia status, and frailty status, are well-known prognostic factors for OS in head and neck cancer ( 29 – 32 ). Therefore, 3-methylhistidine levels may indicate host factors, such as general status, rather than cancer aggressiveness.…”

Section: Discussionmentioning

confidence: 99%

Salivary Metabolomics for Prognosis of Oral Squamous Cell Carcinoma

et al. 2022

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This study aimed to identify salivary metabolomic biomarkers for predicting the prognosis of oral squamous cell carcinoma (OSCC) based on comprehensive metabolomic analyses. Quantified metabolomics data of unstimulated saliva samples collected from patients with OSCC (n = 72) were randomly divided into the training (n = 35) and validation groups (n = 37). The training data were used to develop a Cox proportional hazards regression model for identifying significant metabolites as prognostic factors for overall survival (OS) and disease-free survival. Moreover, the validation group was used to develop another Cox proportional hazards regression model using the previously identified metabolites. There were no significant between-group differences in the participants’ characteristics, including age, sex, and the median follow-up periods (55 months [range: 3–100] vs. 43 months [range: 0–97]). The concentrations of 5-hydroxylysine (p = 0.009) and 3-methylhistidine (p = 0.012) were identified as significant prognostic factors for OS in the training group. Among them, the concentration of 3-methylhistidine was a significant prognostic factor for OS in the validation group (p = 0.048). Our findings revealed that salivary 3-methylhistidine is a prognostic factor for OS in patients with OSCC.

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Low skeletal muscle mass as predictor of postoperative complications and decreased overall survival in locally advanced head and neck squamous cell carcinoma: the role of ultrasound of rectus femoris muscle

Cited by 22 publications

References 42 publications

Prognostic impact of sarcopenia in patients with head and neck cancer treated with surgery or radiation: A meta-analysis

Prognostic impact of sarcopenia in patients with head and neck cancer treated with surgery or radiation: A meta-analysis

Low skeletal muscle mass predicts relevant clinical outcomes in head and neck squamous cell carcinoma. A meta analysis

Salivary Metabolomics for Prognosis of Oral Squamous Cell Carcinoma

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