Sarcopenia is a prognostic factor for overall survival in elderly patients with head-and-neck cancer
Sarcopenia is a prognostic factor for overall survival in elderly patients with head-and-neck cancer
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DOI：
10.1007/s00405-019-05361-4
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发表时间：
2019-05-01
影响因子：
2.6
通讯作者：
de Bree, R.
中科院分区：
文献类型：
--
作者：
Chargi, N.;Bril, S., I;de Bree, R.
骨骼肌减少症是一种与老年患者残疾增加和生存率降低相关的老年综合征。在肿瘤患者中，预处理低骨骼肌质量（SMM），有时被称为肌肉减少症，是一个新兴的负面预后因素。通常，仅对癌症患者进行SMM评估。肌少症被定义为低SMM和低肌肉功能（MF）的结合。我们研究了一组老年头颈部鳞状细胞癌（HNSCC）患者的SMM、MF、肌肉减少症（SMM和MF合并）与总生存率（OS）的关系。患者与方法对2015 - 2018年接受治疗的老年HNSCC患者进行回顾性研究。分别探讨SMM和MF与肌少症的预后价值。结果85例患者中48.2%出现肌肉减少症。有治愈意图的肌少症患者（12.07个月；IQR 3.64-21.82）的中位OS明显低于无肌少症患者（13.60个月；IQR 5.98-27.00） （HR 2.80; 95% CI 1.14-6.88; p = 0.03）。SMM和MF分别不是OS的显著预测因子。结论老年HNSCC患者骨骼肌减少与OS受损相关。肌少症，定义为低SMM和低MF的结合，似乎是比低SMM或低MF单独更好的OS预测指标。
Objectives Sarcopenia is known as a geriatric syndrome associated with increased disability and decreased survival in elderly patients. In oncological patients, pretreatment low skeletal muscle mass (SMM), sometimes referred to as sarcopenia, is an emerging negative prognostic factor. Commonly, only SMM is assessed in cancer patients. Sarcopenia is defined as the combination of low SMM and low muscle function (MF). We investigated the relation between SMM, MF, sarcopenia (SMM and MF combined), and overall survival (OS) in a group of elderly patients with head-and-neck squamous cell carcinoma (HNSCC).Patients and methods A retrospective study in elderly HNSCC patients treated between 2015 and 2018 was performed. The prognostic value of SMM and MF seperately, and sarcopenia was investigated.Results Eighty-five patients were included of whom 48.2% had sarcopenia. The median OS was significantly worse for patients treated with curative intent with sarcopenia (12.07 months; IQR 3.64-21.82) compared to patients without sarcopenia (13.60 months; IQR 5.98-27.00) (HR 2.80; 95% CI 1.14-6.88; p = 0.03). SMM and MF seperately were not significant predictors of OS.Conclusion Sarcopenia is associated with impaired OS in elderly HNSCC patients. Sarcopenia, defined as the combination of low SMM and low MF, appears to be a better predictor of OS than low SMM or low MF separately.