Muscle quality and not quantity as a predictor of survival in head and neck squamous cell carcinoma.


Journal

Oral oncology
ISSN: 1879-0593
Titre abrégé: Oral Oncol
Pays: England
ID NLM: 9709118

Informations de publication

Date de publication:
10 2023
Historique:
received: 16 03 2023
revised: 03 07 2023
accepted: 04 08 2023
medline: 18 8 2023
pubmed: 12 8 2023
entrez: 11 8 2023
Statut: ppublish

Résumé

Sarcopenia is frequent in head and neck squamous cell carcinoma (HNSCC), as a consequence of malnutrition related to risk factors or tumoral mass. Treatment is associated with toxicities that lead to reduced calories intake and muscle mass wasting. Sarcopenia has been negatively associated with tumor control and survival outcomes. Our aim is to evaluate the prognostic impact of sarcopenia on overall survival (OS) and progression free survival (PFS) in HNSCC patients undergoing chemoradiation therapy within a prospective clinical trial of chemoradiation vs induction chemotherapy followed by radiation and cetuximab (INTERCEPTOR). On baseline CT or MRI, we investigated the association between OS and PFS with radiological markers of sarcopenia, measured at the third cervical vertebra level. We studied paravertebral skeletal muscles area (cm Imaging of 128 patients was evaluable. We found out that higher body mass index (BMI) was associated with better OS (p = 0.02), and PFS (p = 0.04). Skeletal muscle area (p = 0.02), and IMAT (p = 0.02) were negatively associated with PFS. IMAT was positively correlated with muscle area (Correlation coefficient 0.6, CI95% 0.47-0.7), and negatively associated with muscle density (Correlation coefficient -0.37, CI95% -0.53 - -0.18). IMAT can be used as predictor of PFS in HNC patients undergoing chemoradiation therapy. The amount of intermuscular fat deposits induces alterations of muscle quality, without alterations of muscle quantity, influencing patients' prognosis.

Sections du résumé

BACKGROUND
Sarcopenia is frequent in head and neck squamous cell carcinoma (HNSCC), as a consequence of malnutrition related to risk factors or tumoral mass. Treatment is associated with toxicities that lead to reduced calories intake and muscle mass wasting. Sarcopenia has been negatively associated with tumor control and survival outcomes.
PURPOSE
Our aim is to evaluate the prognostic impact of sarcopenia on overall survival (OS) and progression free survival (PFS) in HNSCC patients undergoing chemoradiation therapy within a prospective clinical trial of chemoradiation vs induction chemotherapy followed by radiation and cetuximab (INTERCEPTOR).
MATERIALS AND METHODS
On baseline CT or MRI, we investigated the association between OS and PFS with radiological markers of sarcopenia, measured at the third cervical vertebra level. We studied paravertebral skeletal muscles area (cm
RESULTS
Imaging of 128 patients was evaluable. We found out that higher body mass index (BMI) was associated with better OS (p = 0.02), and PFS (p = 0.04). Skeletal muscle area (p = 0.02), and IMAT (p = 0.02) were negatively associated with PFS. IMAT was positively correlated with muscle area (Correlation coefficient 0.6, CI95% 0.47-0.7), and negatively associated with muscle density (Correlation coefficient -0.37, CI95% -0.53 - -0.18).
CONCLUSIONS
IMAT can be used as predictor of PFS in HNC patients undergoing chemoradiation therapy. The amount of intermuscular fat deposits induces alterations of muscle quality, without alterations of muscle quantity, influencing patients' prognosis.

Identifiants

pubmed: 37567147
pii: S1368-8375(23)00236-1
doi: 10.1016/j.oraloncology.2023.106540
pii:
doi:

Types de publication

Clinical Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

106540

Informations de copyright

Copyright © 2023 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Elisabetta Roberti (E)

Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili, Brescia, Italy; University of Brescia Residency School in Anesthesiology and Intensive Care Medicine, University of Brescia, Brescia, Italy.

Marco Merlano (M)

Department of Medical Oncology, S Croce and Carle Teaching Hospital, Cuneo, Italy.

Marco Ravanelli (M)

Department of Radiology, University of Brescia, Italy.

Andrea Alberti (A)

Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili, Brescia, Italy.

Andrea Esposito (A)

Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili, Brescia, Italy.

Riccardo Gili (R)

UO Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genoa, Italy.

Silvia Spinazzé (S)

Medical Oncology Unit, Ospedale U. Parini, Viale Ginevra 3, 11100 Aosta, Italy.

Cristina Baré (C)

Medical Oncology Unit, Ospedale U. Parini, Viale Ginevra 3, 11100 Aosta, Italy.

Genny Jocollé (G)

Medical Oncology Unit, Ospedale U. Parini, Viale Ginevra 3, 11100 Aosta, Italy.

Marco Benasso (M)

Department of Oncology, San Paolo Hospital, Savona, Italy.

Francesca Bertolotti (F)

Department of Oncology, San Paolo Hospital, Savona, Italy.

Stefania Vecchio (S)

UO Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genova, Italy.

Almalina Bacigalupo (A)

UO Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genova, Italy.

Lisa Licitra (L)

Fondazione IRCCS Istituto Nazionale dei Tumori & University of Milan, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy.

Nerina Denaro (N)

Medical Oncology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.

Mauro Damico (M)

Unit of Medical Oncology, Galliera Hospital, Genoa, Italy.

Luigi Lorini (L)

IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy.

Cristina Gurizzan (C)

Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili, Brescia, Italy.

Salvatore Alfieri (S)

Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy.

Paolo Bossi (P)

IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy. Electronic address: paolo.bossi@hunimed.eu.

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