Bonavolontà Paola, Improta Giovanni, Dell'Aversana Orabona Giovanni, Goglia Federica, Abbate Vincenzo, Sorrentino Alfonso, Piloni Sara, Salzano Giovanni, Iaconetta Giorgio, Califano Luigi
Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy.
Department of Public Health, Federico II University of Naples, Naples, Italy.
J Craniomaxillofac Surg. 2023 Jan;51(1):7-15. doi: 10.1016/j.jcms.2023.01.014. Epub 2023 Jan 30.
This retrospective single-center study aimed to evaluate the relevance of sarcopenia and sarcopenic obesity as negative prognostic factors in patients with oral squamous cell carcinoma (OSCC). The study was performed on patients who underwent oral squamous cell carcinoma resection surgery. Patients' demographic and clinical variables were collected at diagnosis (sex, age, height, weight, comorbidities, smoke and alcohol consumption, HPV positivity, TNM-stage) and corrected for known prognostic factors (age, body mass index, TNM-stage). The Skeletal Muscle Mass (SMM) and the Cross-Sectional Area (CSA) on pre-treatment CT scans and Body Mass Index (BMI) were measured to assess sarcopenia and sarcopenic obesity correlated to overall survival (OS). Chi-square statistics were used to analyze the differences between the frequencies of each categorical variable with the presence or absence of sarcopenia and sarcopenic obesity. The cumulative overall survival was calculated by the Kaplan-Meier method, and the differences between curves were evaluated by the log-rank test. A Cox proportional hazard regression model was used for univariate and multivariate analysis of the overall survival. Within the limitations of the study, in this sample, sarcopenia did not seem to cause a statistically significant reduction in the overall survival in patients with oral squamous cell carcinoma (Log Rank χ2 = 3.67, p = 0.055; HR 0.996, 95% CI 0.732-1.354, p = 0.979), however, sarcopenic obesity showed a meaningful negative prognostic impact on it (Log Rank χ2 = 5.71, p = 0.017; HR 0.985, 95% CI 0.424-2.286, p = 0.972). Within the limitations of the study it seems that sarcopenic obesity, age, BMI, and TNM-stage are more relevant negative prognostic factors, influencing overall survival in surgically treated OSCC, than sarcopenia.
这项回顾性单中心研究旨在评估肌肉减少症和肌肉减少性肥胖作为口腔鳞状细胞癌(OSCC)患者不良预后因素的相关性。该研究针对接受口腔鳞状细胞癌切除术的患者进行。在诊断时收集患者的人口统计学和临床变量(性别、年龄、身高、体重、合并症、吸烟和饮酒情况、HPV阳性、TNM分期),并对已知的预后因素(年龄、体重指数、TNM分期)进行校正。测量治疗前CT扫描的骨骼肌质量(SMM)和横截面积(CSA)以及体重指数(BMI),以评估与总生存期(OS)相关的肌肉减少症和肌肉减少性肥胖。采用卡方统计分析各分类变量在有无肌肉减少症和肌肉减少性肥胖情况下的频率差异。采用Kaplan-Meier法计算累积总生存期,并通过对数秩检验评估曲线间差异。使用Cox比例风险回归模型对总生存期进行单因素和多因素分析。在本研究的局限性范围内,在该样本中,肌肉减少症似乎并未导致口腔鳞状细胞癌患者的总生存期出现统计学上的显著降低(对数秩χ2 = 3.67,p = 0.055;风险比0.996,95%置信区间0.732 - 1.354,p = 0.979),然而,肌肉减少性肥胖对其显示出有意义的不良预后影响(对数秩χ2 = 5.71,p = 0.017;风险比0.985,95%置信区间0.424 - 2.286,p = 0.972)。在本研究的局限性范围内,似乎肌肉减少性肥胖、年龄、BMI和TNM分期比肌肉减少症更相关的不良预后因素,影响手术治疗的OSCC患者的总生存期。