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

Authors

Brennan Olson
Jared Edwards
Catherine Degnin
Nicole Santucci
Michelle Buncke
Jeffrey Hu
Yiyi Chen
Clifton D Fuller
Mathew Geltzeiler
Aaron J Grossberg
Daniel Clayburgh

Publication Date

1-1-2022

Journal

Frontiers in Oncology

Abstract

Background: Sarcopenia 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.

Methods: This 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.

Results: Skeletal 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).

Conclusions: This 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.

Keywords

head and neck cancer, squamous cell carcinoma, surgery, sarcopenia, cachexia, muscle wasting, body composition

DOI

10.3389/fonc.2022.812159

PMID

35237517

PMCID

PMC8882831

PubMedCentral® Posted Date

2-14-2022

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes