ONCOmmunity

Poor treatment tolerance in head and neck cancer patients with low muscle mass.

By: Marco A Mascarella, Terral Patel, Varun Vendra, Lauren Gardiner, Marie-Jeanne Kergoat, Mark W Kubik, Mario G Solari, Carl H Snyderman, Katie S Traylor, Robert L Ferris, Seungwon Kim, Umamaheswar Duvvuri, Shaum S Sridharan

Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
2021-12-05; doi: 10.1002/hed.26978

Abstract

Background

We ascertain the role of a low cervical paraspinal skeletal muscle index (CPSMI) as a biomarker for poor treatment tolerance in patients with operable mucosal head and neck squamous cell carcinoma (HNSCC).

Methods

A prospective cohort of patients with operable HNSCC requiring microvascular reconstruction was evaluated. Low CPSMI was calculated using preoperative CT neck imaging. Poor treatment tolerance, a composite measure of incomplete therapy or severe morbidity/mortality during treatment, was the primary outcome.

Results

One hundred and twenty-seven patients underwent extirpative surgery with a mean age was 60.5. Poor treatment tolerance occurred in 71 (56%) patients with 21 not completing recommended adjuvant therapy and 66 having severe treatment-related morbidity. A low CPSMI was independently associated with poor treatment tolerance (OR 2.49, 95%CI 1.10-5.93) and delay to adjuvant therapy (OR 4.48, 95%CI 1.07-27.6) after adjusting for multiple confounders.

Conclusion

Low CPSMI was independently associated with poor treatment tolerance in patients with operable HNSCC.