Sarcopenia with inflammation predicts poor survival in head and neck cancer: Study
Japan: The combination of sarcopenia and systemic inflammation is useful for identifying the head and neck cancer (HNC) patients at risk for poor survival outcomes, finds a recent study in the journal Auris Nasus Larynx.
The findings showed that systemic inflammation is significantly associated with sarcopenia. The oncological and survival effects of sarcopenia were strengthened when the platelet-lymphocyte ratio (PLR) was high.
Prior to the study, it was known that both sarcopenia and systemic inflammation affects the outcomes of HNC patients. The association between sarcopenia and systemic inflammation and the combined prognostic effect of these factors in HNC patients, however, remains unknown. Kohei Yamahara, Department of Otolaryngology, Head and Neck Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Japan, and colleagues aimed to evaluate the effect of sarcopenia with systemic inflammation on survival and disease control in HNC patients.
For this purpose, the researchers retrospectively reviewed the medical records of HNC patients who were treated between 2009 and 2016. The skeletal muscle area was measured using a single computed tomography image slice at the level of the third cervical vertebra.
A prognostic score (SPLR) was developed based on sarcopenia and the platelet-lymphocyte ratio (PLR), and its prognostic value was evaluated. Overall, 164 patients were enrolled.
Key findings of the study include:
- In the multivariate analysis, sarcopenia was significantly associated with poor overall survival (OS).
- However, neither sarcopenia nor a high PLR was an independent prognostic factor for disease-free survival (DFS) or locoregional recurrence-free survival (LRFS).
- A high PLR was an independent predictor for sarcopenia.
- A high SPLR was associated with older age, lower serum hemoglobin, and lower body mass index.
- Multivariate analysis revealed that SPLR was a significant independent predictor of OS, DFS, and LRFS.
"Systemic inflammation is significantly associated with sarcopenia. The survival and oncological effects of sarcopenia were enhanced when PLR was high," wrote the authors. "Thus, the combination of these two parameters may be useful for identifying HNC patients at risk of poor survival outcomes."
The study titled, "Sarcopenia with inflammation as a predictor of survival in patients with head and neck cancer," is published in the journal Auris Nasus Larynx.