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European Archives of Oto-Rhino-Laryngology

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Open Access 01-05-2019 | Sarcopenia | Head & Neck

Sarcopenia is a prognostic factor for overall survival in elderly patients with head-and-neck cancer

Authors: N. Chargi, S. I. Bril, M. H. Emmelot-Vonk, R. de Bree

Published in: European Archives of Oto-Rhino-Laryngology | Issue 5/2019

Abstract

Objectives

Sarcopenia is known as a geriatric syndrome associated with increased disability and decreased survival in elderly patients. In oncological patients, pretreatment low skeletal muscle mass (SMM), sometimes referred to as sarcopenia, is an emerging negative prognostic factor. Commonly, only SMM is assessed in cancer patients. Sarcopenia is defined as the combination of low SMM and low muscle function (MF). We investigated the relation between SMM, MF, sarcopenia (SMM and MF combined), and overall survival (OS) in a group of elderly patients with head-and-neck squamous cell carcinoma (HNSCC).

Patients and methods

A retrospective study in elderly HNSCC patients treated between 2015 and 2018 was performed. The prognostic value of SMM and MF seperately, and sarcopenia was investigated.

Results

Eighty-five patients were included of whom 48.2% had sarcopenia. The median OS was significantly worse for patients treated with curative intent with sarcopenia (12.07 months; IQR 3.64–21.82) compared to patients without sarcopenia (13.60 months; IQR 5.98-27.00) (HR 2.80; 95% CI 1.14–6.88; p = 0.03). SMM and MF seperately were not significant predictors of OS.

Conclusion

Sarcopenia is associated with impaired OS in elderly HNSCC patients. Sarcopenia, defined as the combination of low SMM and low MF, appears to be a better predictor of OS than low SMM or low MF separately.

Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinkova E, Vandewoude M, Zamboni M (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on sarcopenia in older people. Age Ageing 39(4):412–423. https://doi.org/10.1093/ageing/afq034 CrossRefPubMedPubMedCentral

von Haehling S, Morley JE, Anker SD (2010) An overview of sarcopenia: facts and numbers on prevalence and clinical impact. J Cachexia Sarcopenia Muscle 1(2):129–133. https://doi.org/10.1007/s13539-010-0014-2 CrossRef

Rolland Y, Van Kan G, Abellan, Gillete-Guyonnet S, Vellas B (2011) Cachexia versus sarcopenia. Curr Opin Clin Nutr Metab Care 14:15–21. https://doi.org/10.1097/MCO.0b013e328340c2c2

Goodpaster BH, Park SW, Harris TB, Kritchevsky SB, Nevitt M, Schwartz AV, Simonsick EM, Tylavsky FA, Visser M, Newman AB (2006) The loss of skeletal muscle strength, mass, and quality in older adults: the health, aging and body composition study. J Gerontol Ser A Biol Sci Med Sci 61(10):1059–64. (PMID: 17077199) CrossRef

Janssen I, Baumgartner RN, Ross R, Rosenberg IH, Roubenoff R (2004) Skeletal muscle cutpoints associated with elevated physical disability risk in older men and women. Am J Epidemiol 159(4):413–421. (PMID: 14769646) CrossRef

Shachar SS, Williams GR, Muss HB, Nishijima TF (2016) Prognostic value of sarcopenia in adults with solid tumours: A meta-analysis and systematic review. Eur J Cancer 57:58–67. https://doi.org/10.1016/j.ejca.2015.12.030 CrossRefPubMed

Wendrich AW, Swartz JE, Bril SI, Wegner I, de Graeff A, Smid EJ, de Bree R, Pothen AJ (2017 Aug) 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.2017.05.012 CrossRefPubMed

Prado CM, Baracos VE, McCargar LJ, Reiman T, Mourtzakis M, Tonkin K, Mackey JR, Koski S, Pituskin E, Sawyer MB (2009) Sarcopenia as a determinant of chemotherapy toxicity and time to tumor progression in metastastic breast cancer patients receiving capecitabine treatment. Clin Cancer Res 15(8):2920–6. https://doi.org/10.1158/1078-0432.CCR-08-2242 CrossRefPubMed

Antoun S, Baracos VE, Escudier B, Sawyer MB (2010) Low body mass index and sarcopenia associated with dose-limiting toxicity of sorafenib in patients with renal cell carcinoma. Ann Oncol 21:1594–1598. https://doi.org/10.1093/annonc/mdp605 CrossRefPubMed

10.

Achim V, Bash J, Mowery A, Guimaraes AR, Li R, Schindler J, Wax M, Andersen P, Clayburgh D (2017) Prognostic indication of sarcopenia for wound complication after total laryngectomy. JAMA Otolaryngol Head Neck Surg 143(12):1159–1165. https://doi.org/10.1001/jamaoto.2017.0547 CrossRefPubMed

11.

Bril SI, Pezier TF, Tijink BM, Janssen LM, Braunius WW, de Bree R (2019) Preoperative low skeletal muscle mass as a risk factor for pharyngocutaneous fistula and decreased overall survival in patients undergoing total laryngectomy. Head Neck. https://doi.org/10.1002/hed.25638 CrossRefPubMedPubMedCentral

12.

Ida S, Watanabe M, Yoshida N, Baba Y, Umezaki N, Harada K, Karashima R, Imamura Y, Iwagami S, Baba H (2015) Sarcopenia is a predictor of postoperative respiratory complications in patients with esophageal cancer. Ann Surg Oncol 22(13):4432–4437. https://doi.org/10.1245/s10434-015-4559-3 CrossRefPubMed

13.

van Vugt JL, Braam HJ, van Oudheusden TR, Vestering A, Bollen TL, Wiezer MJ, de Hingh IH, van Ramshorst B, Boerma D (2015) Skeletal muscle depletion is associated with severe postoperative complications in patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis of colorectal cancer. Ann Surg Oncol 22(11):3625–3631. https://doi.org/10.1245/s10434-015-4429-z CrossRefPubMed

14.

Nishikawa D, Hanai N, Suzuki H, Koide Y, Beppu S, Hasegawa Y (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/10.1159/000485515 CrossRefPubMed

15.

Miyamoto Y, Baba Y, Sakamoto Y, Ohuchi M, Tokunaga R, Kurashige J, Hiyoshi Y, Iwagami S, Yoshida N, Yoshida M, Watanabe M, Baba H (2015) Sarcopenia is a negative prognostic factor after curative resection of colorectal cancer. Ann Surg Oncol 22:2663–2668. https://doi.org/10.1245/s10434-014-4281-6 CrossRefPubMed

16.

Okumura S, Kaido T, Hamaguchi Y, Fujimoto Y, Masui T, Mizumoto M, Hammad A, Mori A, Takaori K, Uemoto S (2015) Impact of preoperative quality as well as quantity of skeletal muscle on survival after resection of pancreatic cancer. Surgery 157(6):1088–1098. https://doi.org/10.1016/j.surg.2015.02.002 CrossRefPubMed

17.

Fukuda Y, Yamamoto K, Hirao M et al (2016) Sarcopenia is associated with severe postoperative complications in elderly gastric patients undergoing gastrectomy. Gastric Cancer 19(3):986–993. https://doi.org/10.1007/s10120-015-0546-4 CrossRefPubMed

18.

Heymsfield SB, Wang Z, Baumgartner RN, Ross R (1997) Human body composition: advances in models and methods. Annu Rev Nutr 17:527–558CrossRefPubMed

19.

Swartz JE, Pothen AJ, Wegner I, Smid EJ, Swart KM, de Bree R, Leenen LP, Grolman W (2016) Feasibility of using head and neck CT imaging to assess skeletal muscle mass in head and neck cancer patients. Oral Oncol 62:28–33. https://doi.org/10.1016/j.oraloncology.2016.09.006 CrossRefPubMed

20.

Lauretani F, Russo CR, Bandinelli S, Cavazzini C, Di lorio A, Corsi AM, Rantanen T, Guralnik JM, Ferrucci L (2003) Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol 95(5):1851–1860. https://doi.org/10.1152/japplphysiol.00246.2003 CrossRef

21.

Studenski S, Perera S, Wallace D, Chandler JM, Duncan PW, Rooney E, Fox M, Guralnik JM (2003) Physical performance measures in the clinical setting. J Am Geriatr Soc 51(3): 314–322. (PMID: 12588574) CrossRefPubMed

22.

Morishita S (2016) Prevalence of sarcopenia in cancer patients: review and future directions. Int J Phys Med Rehabil 4:3. https://doi.org/10.4172/2329-9096.1000342 CrossRef

23.

Hairi NN, Cumming RG, Naganathan V, Handelsman DJ, Le Couteur DG, Creasey H, Waite LM, Seibel MJ, Sambrook PN. Loss of muscle strength, mass (sarcopenia), and quality (specific force) and its relationship with functional limitation and physical disability: the concord health and ageing in men project. J Am Geriatr Soc 58 (11):2055–62. https://doi.org/10.1111/j.1532-5415.2010.03145.x

24.

Zoico E, Di Francesco V, Guralnik J, Mazzali G, Bortolani A, Guariento S, Sergi G, Bosello O, Zamboni M (2004) Physical disability and muscular strength in relation to obesity and different body composition indexes in a sample of healthy elderly women. Int J Obes Relat Metab Disord 28(2):234–241. https://doi.org/10.1038/sj.ijo.0802552 CrossRefPubMed

25.

Grotenhuis BA, Shapiro J, van Adrichem S, de Vries M, Koek M, Wijnhoven BPL, van Lanschot J (2016) Sarcopenia/muscle mass is not a prognostic factor for short- and long-term outcome after esophagectomy for cancer. World J Surg 40(11):2698–2704. https://doi.org/10.1007/s00268-016-3603-1 CrossRefPubMedPubMedCentral

26.

Awad S, Tan BH, Cui H, Bhalla A, Fearon KC, Pearsons SL, Catton JA, Lobo DN (2012) Marked changes in body composition following neoadjuvant chemotherapy for oesophagogastric cancer. Clin Nutr 31:74–77. https://doi.org/10.1016/j.clnu.2011.08.008 CrossRefPubMed

27.

Yip C, Goh V, Davies A, Gossage J, Mitchell-Hay R, Hynes O, Maisey N, Ross P, Gaya A, Landau DB, Cook GJ, Griffin N, Mason R (2014) Assessment of sarcopenia and changes in body composition after neoadjuvant chemotherapy and associations with clinical outcomes in oesophageal cancer. Eur Radiol 24:998–1005. https://doi.org/10.1007/s00330-014-3110-4 CrossRefPubMed

28.

Sheetz KH, Zhao L, Holcombe SA, Wang SC, Reddt RM, Lin J, Orringer MB, Chang AC (2013) Decreased core muscle size is associated with worse patient survival following esophagectomy for cancer. Dis Esophagus 26:716–722. https://doi.org/10.1111/dote.12020 CrossRefPubMedPubMedCentral

29.

Pamoukdjian F, Bouillet T, Levy V, Soussan M, Zelek L, Paillaud E (2018) Prevalence and predictive value of pre-therapeutic sarcopenia in cancer patients: a systematic review. Clin Nutr 37(4):1101–1113. https://doi.org/10.1016/j.clnu.2017.07.010 CrossRefPubMed

30.

Zhuang CL, Huang DD, Pang WY, Zhou CJ, Wang SL, Lou N, Ma LL, Yu Z, Shen X (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(13):e3164. https://doi.org/10.1097/MD.0000000000003164 CrossRefPubMedPubMedCentral

31.

Prado CM, Lieffers JR, McCargar LJ, Reiman T, Sawyer MB, Martin L 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(7):629–635. https://doi.org/10.1016/S1470-2045(08)70153-0 CrossRefPubMed

32.

Shen W, Punyanitya M, Wang Z, Gallagher D, St-Onge MP, Albu J et al (2004) Total body skeletal muscle and adipose tissue volumes: estimation from a single abdominal cross-sectional image. J Appl Physiol (1985) 97(6):2333–2338. https://doi.org/10.1152/japplphysiol.00744.2004 CrossRef

Title: Sarcopenia is a prognostic factor for overall survival in elderly patients with head-and-neck cancer
Authors: N. Chargi
S. I. Bril
M. H. Emmelot-Vonk
R. de Bree
Publication date: 01-05-2019
Publisher: Springer Berlin Heidelberg
Keyword: Sarcopenia
Published in: European Archives of Oto-Rhino-Laryngology / Issue 5/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-019-05361-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Sarcopenia is a prognostic factor for overall survival in elderly patients with head-and-neck cancer

Abstract

Objectives

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Patients and methods

Results

Conclusion

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