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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.

Rosenberg IH (1989) Summary comments. Am J Clin Nutr 50:1231–1233. https://doi.org/10.1093/ajcn/50.5.1231CrossRef

Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European working group on sarcopenia in older people. Age Ageing 39:412–423. https://doi.org/10.1093/ageing/afq034CrossRefPubMedPubMedCentral

Chen LK, Liu LK, Woo J et al (2014) Sarcopenia in Asia: consensus report of the Asian working group for sarcopenia. J Am Med Dir Assoc 15:95–101. https://doi.org/10.1016/j.jamda.2013.11.025CrossRefPubMed

Arends J, Baracos V, Bertz H et al (2017) ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr 36:1187–1196. https://doi.org/10.1016/j.clnu.2017.06.017CrossRefPubMed

Ida S, Watanabe M, Yoshida N et al (2015) Sarcopenia is a predictor of postoperative respiratory complications in patients with esophageal cancer. Ann Surg Oncol 22:4432–4437. https://doi.org/10.1245/s10434-015-4559-3CrossRefPubMed

Anandavadivelan P, Brismar TB, Nilsson M, Johar AM, Martin L (2016) Sarcopenic obesity: a probable risk factor for dose limiting toxicity during neo-adjuvant chemotherapy in oesophageal cancer patients. Clin Nutr 35:724–730. https://doi.org/10.1016/j.clnu.2015.05.011CrossRefPubMed

Zhuang CL, Huang DD, Pang WY et al (2016) Sarcopenia is an independent predictor of severe postoperative complications and long-term survival after radical gastrectomy for gastric cancer: analysis from a large-scale cohort. Medicine 95:e3164. https://doi.org/10.1097/MD.0000000000003164CrossRefPubMedPubMedCentral

Huang DD, Chen XX, Chen XY et al (2016) Sarcopenia predicts 1-year mortality in elderly patients undergoing curative gastrectomy for gastric cancer: a prospective study. J Cancer Res Clin Oncol 142:2347–2356. https://doi.org/10.1007/s00432-016-2230-4CrossRefPubMed

Nishikawa H, Nishijima N, Enomoto H et al (2017) Prognostic significance of sarcopenia in patients with hepatocellular carcinoma undergoing sorafenib therapy. Oncol Lett 14:1637–1647. https://doi.org/10.3892/ol.2017.6287CrossRefPubMedPubMedCentral

10.

Huillard O, Mir O, Peyromaure M et al (2013) Sarcopenia and body mass index predict sunitinib-induced early dose-limiting toxicities in renal cancer patients. Br J Cancer 108:1034–1041. https://doi.org/10.1038/bjc.2013.58CrossRefPubMedPubMedCentral

11.

Prado CM, Lieffers JR, McCargar LJ et al (2008) Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol 9:629–635. https://doi.org/10.1016/S1470-2045(08)70153-0CrossRefPubMed

12.

Matsuyama H, Yamazaki K, Okabe R et al (2018) Multicenter phase I/II study of chemoradiotherapy with high-dose CDDP for head and neck squamous cell carcinoma in Japan. Auris Nasus Larynx 45:1086–1092. https://doi.org/10.1016/j.anl.2018.02.008CrossRefPubMed

13.

Eisenhauer EA, Therasse P, Bogaerts J et al (2009) New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 45:228–247. https://doi.org/10.1016/j.ejca.2008.10.026CrossRefPubMed

14.

Yoshida D, Suzuki T, Shimada H et al (2014) Using two different algorithms to determine the prevalence of sarcopenia. Geriatr Gerontol Int 14:46–51. https://doi.org/10.1111/ggi.12210CrossRefPubMed

15.

Yoshimura N, Muraki S, Oka H et al (2017) Is osteoporosis a predictor for future sarcopenia or vice versa? Four-year observations between the second and third ROAD study surveys. Osteoporos Int 28:189–199. https://doi.org/10.1007/s00198-016-3823-0CrossRefPubMed

16.

Pressoir M, Desné S, Berchery D et al (2010) Prevalence, risk factors and clinical implications of malnutrition in French comprehensive cancer centres. Br J Cancer 102:966–971. https://doi.org/10.1038/sj.bjc.6605578CrossRefPubMedPubMedCentral

17.

Wendrich AW, Swartz JE, Bril SI et al (2017) Low skeletal muscle mass is a predictive factor for chemotherapy dose-limiting toxicity in patients with locally advanced head and neck cancer. Oral Oncol 71:26–33. https://doi.org/10.1016/j.oraloncology.2017.05.012CrossRefPubMed

18.

Bril SI, Pezier TF, Tijink BM et al (2019) Preoperative low skeletal muscle mass as a risk factor for pharyngocutaneous fistula and decreased overall survival in patients undergoing total laryngectomy. Head Neck 41:1745–1755. https://doi.org/10.1002/hed.25638CrossRefPubMedPubMedCentral

19.

Nishikawa D, Hanai N, Suzuki H et al (2018) The impact of skeletal muscle depletion on head and neck squamous cell carcinoma. ORL J Otorhinolaryngol Relat Spec 80:1–9. https://doi.org/10.1159/000485515CrossRefPubMed

20.

Levolger S, van Vugt JL, de Bruin RW, IJzermans JN (2015) Systematic review of sarcopenia in patients operated on for gastrointestinal and hepatopancreatobiliary malignancies. Br J Surg 102:1448–1458. https://doi.org/10.1002/bjs.9893CrossRefPubMed

21.

van de Bokhorst, van der Schueren MA, van Leeuwen PA, Sauerwein HP et al (1997) Assessment of malnutrition parameters in head and neck cancer and their relation to postoperative complications. Head Neck 19:419–425. https://doi.org/10.1002/(SICI)1097-0347(199708)19:5<419:AID-HED9>3.0.CO;2-2CrossRef

22.

Langius JA, Bakker S, Rietveld DH et al (2013) Critical weight loss is a major prognostic indicator for disease-specific survival in patients with head and neck cancer receiving radiotherapy. Br J Cancer 109:1093–1099. https://doi.org/10.1038/bjc.2013.458CrossRefPubMedPubMedCentral

23.

Smith KL, Tisdale MJ (1993) Increased protein degradation and decreased protein synthesis in skeletal muscle during cancer cachexia. Br J Cancer 67:680–685. https://doi.org/10.1038/bjc.1993.126CrossRefPubMedPubMedCentral

24.

Van Cutsem E, Arends J (2005) The causes and consequences of cancer-associated malnutrition. Eur J Oncol Nurs 9:S51–S63. https://doi.org/10.1016/j.ejon.2005.09.007CrossRefPubMed

25.

Matsuo S, Imai E, Horio M et al (2009) Collaborators developing the Japanese equation for estimated GFR. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis 53:982–992. https://doi.org/10.1053/j.ajkd.2008.12.034CrossRefPubMed

26.

Suzuki Y, Matsushita K, Seimiya M et al (2012) Serum cystatin C as a marker for early detection of chronic kidney disease and grade 2 nephropathy in Japanese patients with type 2 diabetes. Clin Chem Lab Med 50:1833–1839. https://doi.org/10.1515/cclm-2011-0777CrossRefPubMed

27.

Horio M, Imai E, Yasuda Y et al (2013) Collaborators developing the Japanese equation for estimated GFR. GFR estimation using standardized serum cystatin C in Japan. Am J Kidney Dis 61:197–203. https://doi.org/10.1053/j.ajkd.2012.07.007CrossRefPubMed

28.

Aslani A, Smith RC, Allen BJ, Pavlakis N, Levi JA (2000) The predictive value of body protein for chemotherapy-induced toxicity. Cancer 88:796–803. https://doi.org/10.1002/(SICI)1097-0142(20000215)88:4<796:AID-CNCR10>3.0.CO;2-PCrossRefPubMed

29.

Tan BH, Brammer K, Randhawa N et al (2015) Sarcopenia is associated with toxicity in patients undergoing neo-adjuvant chemotherapy for oesophago-gastric cancer. Eur J Surg Oncol 41:333–338. https://doi.org/10.1016/j.ejso.2014.11.040CrossRefPubMed

30.

Prado CM, Baracos VE, McCargar LJ et al (2017) Body composition as an independent determinant of 5-fluorouracil-based chemotherapy toxicity. Clin Cancer Res 13:3264–3268. https://doi.org/10.1158/1078-0432.CCR-06-3067CrossRef

31.

Yoshimura Y, Uchida K, Jeong S, Yamaga M (2016) Effects of nutritional supplements on muscle mass and activities of daily living in elderly rehabilitation patients with decreased muscle mass: a randomized controlled trial. J Nutr Health Aging 20:185–191. https://doi.org/10.1007/s12603-015-0570-4CrossRefPubMed

32.

Atherton PJ, Smith K, Etheridge T, Rankin D, Rennie MJ (2010) Distinct anabolic signalling responses to amino acids in C2C12 skeletal muscle cells. Amino Acids 38:1533–1539. https://doi.org/10.1007/s00726-009-0377-xCrossRefPubMed

33.

Cruz-Jentoft AJ, Landi F, Schneider SM et al (2014) Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the international sarcopenia initiative (EWGSOP and IWGS). Age Ageing 43:748–759. https://doi.org/10.1093/ageing/afu115CrossRefPubMedPubMedCentral

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

Abstract

Purpose

Methods

Results

Conclusion

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Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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