Skeletal muscle mass is an imaging biomarker for decreased survival in patients with oropharyngeal squamous cell carcinoma.
OBJECTIVES
Low skeletal muscle mass (SMM) and sarcopenic obesity (co-presence of low SMM and obesity) are emerging prognosticators in oncology, but the prevalence and prognostic value in oropharyngeal squamous cell carcinoma (OPSCC) is not yet known.


MATERIALS AND METHODS
Patients with OPSCC, curative treatment intention and pre-treatment diagnostic imaging of the head and neck area were included. Patients with unknown HPV-status, palliative treatment intention or unavailable imaging were excluded, Relevant demographic and clinical characteristics were collected between 2009 and 2016. Patients were stratified into a low-, intermediate-, and high-risk group according to HPV-status, amount of pack-years, tumor and nodal stage. SMM was radiologically measured and cutoff values were determined by optimal stratification. The prognostic value of low SMM and sarcopenic obesity for overall survival (OS) and disease-free survival (DFS) was determined by Cox regression analysis and Kaplan Meier survival curves.


RESULTS
In 216 patients, low SMM and sarcopenic obesity were present in 140 (64.8%) and 13 (6.0%) patients, respectively. On multivariate analysis, stratification into a high-risk group (HPV-negative status with ≥10-pack-years or T4-stage) was a prognostic factor for OS and DFS (HR 2.93, p < 0.01) (HR 4.66, p < 0.01). Of specific interest, sarcopenic obesity was a strong negative prognostic factor for OS and DFS (HR 4.42, p < 0.01 and (HR 3.90, p < 0.05), independent from other well-known prognostic factors such as HPV-status.


CONCLUSION
Low skeletal muscle mass is highly prevalent in OPSCC patients. Sarcopenic obesity is a novel pretreatment prognosticator for OS and DFS in OPSCC and should therefore be considered in clinical decision making.
['Chargi|N|N|', 'Bril|S I|SI|', 'Swartz|J E|JE|', 'Wegner|I|I|', 'Willems|S M|SM|', 'de Bree|R|R|']
D015415:Biomarkers D001823:Body Composition D002294:Carcinoma, Squamous Cell D005260:Female D006801:Humans D053208:Kaplan-Meier Estimate D008297:Male D018482:Muscle, Skeletal D009959:Oropharyngeal Neoplasms D000072078:Positron Emission Tomography Computed Tomography D011379:Prognosis D016016:Proportional Hazards Models D012189:Retrospective Studies D055948:Sarcopenia
Skeletal muscle mass Sarcopenic obesity Body composition Head and neck cancer Human papillomavirus Oropharyngeal cancer Sarcopenia