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The impact of skeletal muscle depletion on older adult patients with head and neck cancer undergoing primary surgery

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Abstract
Introduction: Sarcopenia may result in negative outcomes in patients with cancer, but its impact on surgical and oncological outcomes in older adult patients with head and neck squamous cell carcinoma (HNSCC) has not been systematically studied. This study evaluated the clinical impact of sarcopenia on postsurgical and oncological outcomes in older adult patients with HNSCC.

Methods: This is a prospective study of 190 consecutive HNSCC patients aged >= 65 years who underwent curative surgery at a tertiary referral hospital. Sarcopenia was determined from measurement of the cross-sectional area of skeletal muscles at the level of the third lumbar vertebra on pretreatment images of whole body F-18-fluorodeoxyglucose positron emission tomography/computed tomography. Primary outcomes were early complications and overall survival. Factors of early complications and readmission were identified using binary logistic regression analyses, and factors of overall survival and disease-free survival were identified using univariate and multivariate Cox proportional hazards regression analyses.

Results: Pretreatment sarcopenia were found in 64 (33.7%) patients. In multivariate analysis, sarcopenia and N classification were significantly associated with early complications, while sarcopenia and T classification were associated with readmission. Independent factors of overall survival outcomes were age, sarcopenia, and extranodal extension (all P < .005). Sarcopenia was also an independent factor predictive of disease-free survival outcome (P < .001). Sarcopenia was associated with a 3.2-fold increase in the early complication rate and 4.5-fold increase in mortality in older adult surgical patients with HNSCC.

Conclusion: Sarcopenia may predict early complications and survival after curative surgery in older adult patients with HNSCC. (C) 2020 Elsevier Ltd. All rights reserved.
Author(s)
김상윤김재승남순열노종렬정아라최승호
Issued Date
2021
Type
Article
Keyword
ComplicationsHead and neck squamous cell carcinomaOlder adultsSarcopeniaSurvival
DOI
10.1016/j.jgo.2020.06.009
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7908
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2415834736&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,The%20impact%20of%20skeletal%20muscle%20depletion%20on%20older%20adult%20patients%20with%20head%20and%20neck%20cancer%20undergoing%20primary%20surgery&amp;offset=0&amp;pcAvailability=true
Publisher
JOURNAL OF GERIATRIC ONCOLOGY
Location
네덜란드
Language
영어
ISSN
1879-4068
Citation Volume
12
Citation Number
1
Citation Start Page
128
Citation End Page
133
Appears in Collections:
Medicine > Medicine
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