1. Prognostic value of body composition on recurrence and survival of advanced-stage head and neck cancer.
- Author
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Jung, Ah Ra, Roh, Jong-Lyel, Kim, Jae Seung, Kim, Sung-Bae, Choi, Seung-Ho, Nam, Soon Yuhl, and Kim, Sang Yoon
- Subjects
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CANCER relapse , *HEAD & neck cancer treatment , *CANCER treatment , *ADIPOSE tissues , *BLOOD protein disorders , *BODY composition , *COMPUTED tomography , *DEOXY sugars , *LONGITUDINAL method , *LUMBAR vertebrae , *MULTIVARIATE analysis , *HEAD & neck cancer , *ONCOGENES , *RADIOPHARMACEUTICALS , *SQUAMOUS cell carcinoma , *STATISTICS , *SURVIVAL , *TUMOR classification , *MULTIPLE regression analysis , *BODY mass index , *TREATMENT effectiveness , *SARCOPENIA , *PROPORTIONAL hazards models , *LEAN body mass , *SKELETAL muscle , *PROGNOSIS , *CANCER risk factors ,MORTALITY risk factors - Abstract
Head and neck squamous cell carcinoma (HNSCC) is commonly associated with a high risk of malnutrition and sarcopenia, related to adverse clinical outcomes. This study evaluated the prognostic values of body composition on recurrence and survival in patients with advanced-stage HNSCC. This study prospectively enrolled 258 consecutive patients with definitive treatments for advanced-stage HNSCC. For the determination of sarcopenia, the cross-sectional area of the skeletal muscles (SMs) was measured at the level of the third lumbar vertebra on the computed tomography images of whole-body 18F-fluorodeoxyglucose positron-emission tomography/computed tomography before and after treatments. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify the prognostic factors of disease-free survival (DFS) and overall survival (OS). Pretreatment and post-treatment diminished SM masses (sarcopenia) were found in 17 (6.6%) and 32 (12.4%) of 258 included patients, respectively. All values of body composition, SM index, visceral fat area, lean body mass, fat mass and body mass index significantly decreased after treatment (all P < 0.05). Multivariable analyses showed that age, Charlson comorbidity index, pretreatment and post-treatment sarcopenia, pretreatment hypoalbuminaemia, p16 status and tumour site remained the independent variables predictive of DFS and OS outcomes (all P < 0.05). Patients with sarcopenia before or after treatment had about threefold increased risk of overall recurrence or death. Diminished SM mass may predict recurrence and survival after definitive treatments in patients with advanced-stage HNSCC. • Skeletal muscle mass was measured from computed tomography images at L3 before and after treatment. • Pretreatment and post-treatment sarcopenia were found in 6.6% and 12.4%, respectively. • Most body composition parameters significantly decreased after treatment. • Sarcopenia is the independent risk factor for disease-free and overall survival after treatment. • Sarcopenia was associated with about threefold increased risk of overall recurrence or death. Condensed Abstract : This study evaluated the prognostic values of body composition on recurrence and survival in 258 patients with advanced-stage head and neck squamous cell carcinoma. Sarcopenia was the independent risk factor for poorer disease-free and overall survival outcomes after definitive treatments, showing about threefold increased risk of overall recurrence or death. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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