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

Yoshimura, Tsuyoshi; Suzuki, Hajime; Takayama, Hirotaka; Higashi, Shotaro; Hirano, Yuka; Tezuka, Masahiro; Ishida, Takayuki; Ishihata, Kiyohide; Amitani, Marie; Amitani, Haruka; Nishi, Yasuhiro; Nakamura, Yasunori; Imamura, Yasushi; Nozoe, Etsuro; Nakamura, Norifumi

doi:10.3390/cancers13184725

Cited by 20 publications

(22 citation statements)

References 32 publications

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“…These findings were confirmed in more recent studies [52,53,57]. SMM was also an imaging biomarker for decreased survival in subgroups of patients with oral cancer [58,59] and oropharyngeal squamous cell carcinoma [60], and in elderly HNC patients (when combined with muscle function) [61].…”

Section: Survivalsupporting

confidence: 71%

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: Survivalsupporting

confidence: 71%

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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“…However, identification of this high-risk disease feature is challenging in HNC because imaging studies that capture the abdomen or lower thorax are infrequent in this population. Although previous studies demonstrate promise in utilizing neck imaging as a marker of sarcopenia ( 22 , 25 , 26 , 34 ), we sought to expand upon these foundational studies by putting forth normalized sex-specific sarcopenia thresholds and testing their prognostic utility in an independent cohort of patients with neck imaging alone. To our knowledge, our study is the first to establish normalized sex-specific C3 sarcopenia thresholds and validate their prognostic value in an independent cohort of HNC patients with imaging studies specific to the neck.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, defining and validating sarcopenia thresholds from routinely acquired head and neck images would greatly enhance clinical implementation while allowing better cross-study comparisons. Previous reports demonstrated a significant correlation between cervical and abdominal vertebrae cross sectional muscle area in patients with HNC, suggesting that routine head and neck imaging may be used to identify sarcopenia ( 22 – 26 ). In the present study, we sought to expand upon these findings in a cohort of HNC patients treated with primary surgical resection by defining sex-specific sarcopenia thresholds, evaluating their prognostic value, and validating these associations in an independent patient cohort.…”

Section: Introductionmentioning

confidence: 99%

Establishment and Validation of Pre-Therapy Cervical Vertebrae Muscle Quantification as a Prognostic Marker of Sarcopenia in Patients With Head and Neck Cancer

et al. 2022

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BackgroundSarcopenia is prognostic for survival in patients with head and neck cancer (HNC). However, identification of this high-risk feature remains challenging without computed tomography (CT) imaging of the abdomen or thorax. Herein, we establish sarcopenia thresholds at the C3 level and determine if C3 sarcopenia is associated with survival in patients with HNC.MethodsThis retrospective cohort study was conducted in consecutive patients with a squamous cell carcinoma of the head and neck with cross-sectional abdominal or neck imaging within 60 days prior to treatment. Measurement of cross-sectional muscle area at L3 and C3 levels was performed from CT imaging. Primary study outcome was overall survival.ResultsSkeletal muscle area at C3 was strongly correlated with the L3 level in both men (n = 188; r = 0.77; p < 0.001) and women (n = 65; r = 0.80; p < 0.001), and C3 sarcopenia thresholds of 14.0 cm2/m2 (men) and 11.1 cm2/m2 (women) were best predictive of L3 sarcopenia thresholds. Applying these C3 thresholds to a cohort of patients with neck imaging alone revealed that C3 sarcopenia was independently associated with reduced overall survival in men (HR = 2.63; 95% CI, 1.79, 3.85) but not women (HR = 1.18, 95% CI, 0.76, 1.85).ConclusionsThis study identifies sarcopenia thresholds at the C3 level that best predict L3 sarcopenia in men and women. In HNC, C3-defined sarcopenia is associated with poor survival outcomes in men, but not women, suggesting sarcopenia may differentially affect men and women with HNC.

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“…In addition, tumor-cell-derived proinflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor alpha in turn reduce the hepatic synthesis of albumin 31 . This evidence suggests that cancer-associated malnutrition and cachexia may be accompanied by hypoalbuminemia, skeletal muscle wasting, low physical activity, and poor quality of life, which ultimately contribute to the poor survival outcomes in OSCC 12 , 32 , 33 . The peripheral lymphocyte count is another element of the CALLY index, and lymphocytes play an essential role in initiating and activating the adaptive immune response 34 .…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of CRP-Albumin-Lymphocyte (CALLY) Index in Patients Undergoing Surgery for Oral Cavity Cancer

Tsai¹,

Ko²,

Chen³

et al. 2022

J. Cancer

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Background:The prognostic value of the CRP-albumin-lymphocyte index (CALLY index) was analyzed in patients with oral cavity squamous cell carcinoma (OSCC) undergoing curative surgery. Methods: We retrospectively included 279 patients who were diagnosed as having primary OSCC and being treated with surgery. The optimal cutoff for the preoperative CALLY index was identified by considering the area under the receiver operating characteristic curve; subsequently, the discriminatory ability of the cutoff was determined. We employed Kaplan-Meier analysis and the log-rank test to elucidate associations between the CALLY index and survival outcomes. We identified prognostic variables by using the Cox proportional hazards model. Finally, we devised a nomogram based on the CALLY index for predicting individualized survival. Results: The cutoff value of the CALLY index was determined to be 0.65. A CALLY index < 0.65 exhibited a significant association with pathological aggressiveness as well as shorter overall and disease-free survival (OS and DFS, both P < 0.001). A low CALLY index was an independent risk factor for short OS and DFS [hazard ratio = 3.816; 95% confidence interval (CI) 2.393-6.086; P < 0.001; and hazard ratio = 2.103; 95% CI 1.451-3.049; P < 0.001, respectively] in multivariate Cox analysis. The prognostic nomogram based on the CALLY index yielded accurate predictions of OS, as revealed by a concordance index of 0.797. Conclusions:The preoperative CALLY index is easy and inexpensive to calculate and, in patients with OSCC, can be a valuable prognostic biomarker. The CALLY-index-based nomogram established in this study provides accurate survival predictions.

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

Cited by 20 publications

References 32 publications

Sarcopenia and its impact in head and neck cancer treatment

Sarcopenia and its impact in head and neck cancer treatment

Establishment and Validation of Pre-Therapy Cervical Vertebrae Muscle Quantification as a Prognostic Marker of Sarcopenia in Patients With Head and Neck Cancer

Prognostic Value of CRP-Albumin-Lymphocyte (CALLY) Index in Patients Undergoing Surgery for Oral Cavity Cancer

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