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European Archives of Oto-Rhino-Laryngology

Erschienen in:

08.08.2020 | Head and Neck

Sarcopenia predicts a poor treatment outcome in patients with head and neck squamous cell carcinoma receiving concurrent chemoradiotherapy

verfasst von: Ryusuke Shodo, Keisuke Yamazaki, Yushi Ueki, Takeshi Takahashi, Arata Horii

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 6/2021

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Abstract

Purpose

Sarcopenia, defined as a decrease in the skeletal muscle mass and its function, is associated with a poor clinical outcome in several malignancies. We aimed to examine whether sarcopenia can be a predictor of incompletion of concurrent chemoradiotherapy (CCRT) and survival for head and neck cancer (HNC) patients.

Methods

Forty-one male HNC patients who received CCRT were enrolled in the study. Cross-sectional muscle areas at the third lumbar vertebral level were normalized by the squared height of the patients and were termed the lumbar skeletal muscle index (LSMI, cm²/m²), a marker of sarcopenia. Patients were divided into high (30/41, 73%) and low (11/41, 27%) LSMI groups. The LSMI cut-off value was set at 39.7 cm²/m² based on a receiver operating characteristic curve for incompletion of CCRT. The groups were compared for survival rate by the Kaplan–Meier method. Factors predicting incompletion of CCRT were investigated among several variables.

Results

Multivariate analysis showed that a pre-treatment low LSMI (P = 0.033) and age over 70 years (P = 0.023) were the only significant predictors for incompletion of CCRT. The 2-year disease-specific survival (DSS) rate was significantly lower in the low LSMI group (61%) than in the high LSMI group (97%, P = 0.012), whereas there were no differences in the DSS rate between the low and high body mass index groups.

Conclusion

The prevalence of sarcopenia in HNC patients receiving CCRT was 27%. Its presence before treatment was a significant predictor of incomplete CCRT and poor DSS rate in HNC patients.

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Titel: Sarcopenia predicts a poor treatment outcome in patients with head and neck squamous cell carcinoma receiving concurrent chemoradiotherapy
verfasst von: Ryusuke Shodo
Keisuke Yamazaki
Yushi Ueki
Takeshi Takahashi
Arata Horii
Publikationsdatum: 08.08.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: European Archives of Oto-Rhino-Laryngology / Ausgabe 6/2021
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-020-06273-4

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Sarcopenia predicts a poor treatment outcome in patients with head and neck squamous cell carcinoma receiving concurrent chemoradiotherapy