舌骨下水平的肌肉减少症作为晚期非病毒相关性头颈癌患者的预后因素。
Sarcopenia at the infrahyoid level as a prognostic factor in patients with advanced-stage non-virus-related head and neck carcinoma.
作者信息
Yunaiyama Daisuke, Okubo Mitsuru, Arizono Eri, Tsukahara Kiyoaki, Tanigawa Maki, Nagao Toshitaka, Saito Kazuhiro
机构信息
Department of Radiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan.
出版信息
Eur Arch Otorhinolaryngol. 2022 Jun;279(6):3131-3137. doi: 10.1007/s00405-021-07147-z. Epub 2021 Oct 25.
PURPOSE
The purpose of this study was to assess whether the infrahyoid skeletal muscle index (IHSMI) can be used instead of the L3 skeletal muscle index (L3SMI) to define sarcopenia and predict prognosis in patients with locally advanced head and neck squamous cell carcinoma (LHNSCC).
METHODS
Patients treated for LHNSCC between January 2009 and April 2018 were assessed. The muscular area at the L3 transverse process and infrahyoid was contoured on absorption-corrected computed tomography prior to treatment. Sarcopenia based on L3SMI (S-L) was defined as values of < 52.4 cm/m for men and < 38.5 cm/m for women. Sarcopenia based on IHSMI (S-I) was determined via receiver operating curve analysis. Overall survival (OS) and cause-specific survival (CSS) curves were constructed using the Kaplan-Meier method.
RESULTS
In total, 101 patients were analyzed. The median follow-up period was 19 months (range 3-101 month). S-L and S-I were identified in 74 (73.3%) and 56 patients (55.4%), respectively. The 5-year OS rate did not differ between patients with and without S-L (64.9% vs. 79.2%, p = 0.635), whereas the rate was lower in patients with S-I than without S-I (57.1% vs. 93.0%, p = 0.006). Similarly, the 5-year CSS rate did not differ between patients with and without S-L (77.0% vs. 82.3%, p = 0.523), but the rate was lower in patients with S-I (61.2% vs. 93.0%, p = 0.02).
CONCLUSION
Pretreatment S-I, but not S-L, was a good predictor of OS and CSS in patients with LHNSCC.
目的
本研究旨在评估舌骨下骨骼肌指数（IHSMI）是否可用于替代L3骨骼肌指数（L3SMI）来定义局部晚期头颈部鳞状细胞癌（LHNSCC）患者的肌肉减少症并预测其预后。
方法
对2009年1月至2018年4月期间接受LHNSCC治疗的患者进行评估。在治疗前，通过吸收校正后的计算机断层扫描勾勒出L3横突和舌骨下的肌肉面积。基于L3SMI的肌肉减少症（S-L）定义为男性<52.4 cm/m²，女性<38.5 cm/m²。基于IHSMI的肌肉减少症（S-I）通过受试者工作特征曲线分析确定。采用Kaplan-Meier法构建总生存（OS）曲线和病因特异性生存（CSS）曲线。
结果
共分析了101例患者。中位随访期为19个月（范围3-101个月）。分别在74例（73.3%）和56例（55.4%）患者中发现S-L和S-I。有S-L和无S-L的患者5年OS率无差异（64.9%对79.2%，p = 0.635），而有S-I的患者的5年OS率低于无S-I的患者（57.1%对93.0%，p = 0.006）。同样，有S-L和无S-L的患者5年CSS率无差异（77.0%对82.3%，p = 0.523），但有S-I的患者的5年CSS率较低（61.2%对93.0%，p = 0.02）。
结论
治疗前的S-I而非S-L是LHNSCC患者OS和CSS的良好预测指标。
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