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Clinical Significance of Sarcopenia among Patients with Advanced Oropharyngeal Cancer.
- Source :
-
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2019 Mar; Vol. 160 (3), pp. 480-487. Date of Electronic Publication: 2018 Aug 14. - Publication Year :
- 2019
-
Abstract
- Objectives: We investigated the prevalence and impact of sarcopenia on disease-free survival (DFS) and overall survival (OS) in advanced oropharyngeal cancer.<br />Study Design: Retrospective study.<br />Setting: Single-institution tertiary cancer care center.<br />Subjects and Methods: We identified patients with advanced oropharyngeal cancer with pretreatment positron emission tomography-computed tomography scans for image analysis. Data were collected on the following variables: age, sex, smoking and alcohol status, stage (TNM and American Joint Committee on Cancer), human papillomavirus (HPV) status, body mass index (BMI), and treatment modality.<br />Results: Of 113 patients identified with oropharyngeal cancer, 32 had sarcopenia: these patients were older (63.5 vs 57.6 years, P = .01), were less likely to be male (53.1% vs 76.5%, P = .03), and had a lower mean BMI (24.5 vs 28.4 kg/m <superscript>2</superscript> , P = .009). Eighty-five subjects had HPV-positive disease, and they had a higher BMI (28.2 vs 24.2 kg/m <superscript>2</superscript> , P = .01) than that of patients without HPV. Twenty-one subjects who were HPV positive had less cancer recurrence (24.7% vs 48.1%, P = .04) than that of their HPV-negative counterparts. Log-rank testing showed no difference in DFS ( P = .06) associated with sarcopenia but a significant difference in OS ( P = .049). There were differences in DFS ( P = .009) and OS ( P = .023) based on HPV status. According to univariable and multivariable models, HPV positivity exhibited improved DFS and OS. Sarcopenia was not statistically significant in survival models; however, it was associated with increased mortality and recurrence.<br />Conclusion: Sarcopenia is a prognostic factor affecting OS independent of HPV status in advanced oropharyngeal cancer.
- Subjects :
- Aged
Body Mass Index
Carcinoma, Squamous Cell mortality
Carcinoma, Squamous Cell pathology
Disease-Free Survival
Female
Humans
Male
Middle Aged
Oropharyngeal Neoplasms mortality
Oropharyngeal Neoplasms pathology
Papillomavirus Infections complications
Papillomavirus Infections diagnosis
Positron Emission Tomography Computed Tomography
Prevalence
Retrospective Studies
Sarcopenia diagnosis
Survival Rate
Carcinoma, Squamous Cell complications
Oropharyngeal Neoplasms complications
Sarcopenia epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6817
- Volume :
- 160
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 30105922
- Full Text :
- https://doi.org/10.1177/0194599818793857