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

Frontiers in Oncology

Clifton D. Fuller¹  Brennan Olson¹  Jeffrey Hu¹  Catherine Degnin¹  Aaron J. Grossberg¹  Michelle Buncke²  Nicole Santucci³  Daniel Clayburgh⁴  Jared Edwards⁵  Mathew Geltzeiler⁶  Yiyi Chen⁶ 

[1] Science University, Portland, OR, United States;;Biostatistics Shared Resources, Knight Cancer Institute, Oregon Health &Department of General Surgery, Naval Medical Center San Diego, San Diego, CA, United States;Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States;;Medical Scientist Training Program, Oregon Health &;School of Medicine, Oregon Health &Seagen Inc., Bothell, WA, United States;

关键词: head and neck cancer;    squamous cell carcinoma;    surgery;    sarcopenia;    cachexia;    muscle wasting;   

DOI  :  10.3389/fonc.2022.812159

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown