Syziu A, Schache A
University Hospital Aintree, Fazakerley, Liverpool, UK.
University Hospital Aintree, Fazakerley, Liverpool, UK.
Int J Oral Maxillofac Surg. 2025 Jan;54(1):1-11. doi: 10.1016/j.ijom.2024.07.008. Epub 2024 Jul 26.
The aim of this study was to determine the prognostic value of pre-treatment sarcopenia, defined radiologically (cervical (C3) or lumbar (L3) region), in adult head and neck cancer (HNC) patients undergoing treatment with curative intent. A systematic search of the PubMed and Scopus databases was performed up to March 2024. Inclusion criteria were adult patients with locally advanced HNC, sarcopenia defined radiologically at the C3 and/or L3 level, and patients receiving primary treatment with curative intent. Risk of bias was assessed using the ROBINS-I tool non-randomised studies. Thirty studies involving a total of 6924 adult patients with HNC were included in this review. Pre-treatment sarcopenia was significantly associated with worse overall survival outcomes in 26 of the 30 studies (87%), across all treatment modalities with curative intent. The most frequent sex-specific SMI cut-off values were <52.4 cm/m for males and <38.5 cm/m for females. The findings of this review suggest that sarcopenia is a strong prognostic factor of overall survival in HNC patients undergoing primary curative treatment. Sarcopenia evaluation appears to be a good prognostic marker in the HNC population. Future nutritional interventional studies might focus on reversing the muscle loss and improving overall outcomes in identified sarcopenic individuals.
本研究的目的是确定在接受根治性治疗的成年头颈癌（HNC）患者中，通过影像学定义（颈椎（C3）或腰椎（L3）区域）的治疗前肌肉减少症的预后价值。截至2024年3月，对PubMed和Scopus数据库进行了系统检索。纳入标准为局部晚期HNC成年患者、在C3和/或L3水平通过影像学定义的肌肉减少症，以及接受根治性原发性治疗的患者。使用ROBINS-I工具对非随机研究进行偏倚风险评估。本综述纳入了30项研究，共涉及6924例成年HNC患者。在30项研究中的26项（87%）中，治疗前肌肉减少症与所有根治性治疗方式下更差的总生存结果显著相关。最常见的性别特异性骨骼肌指数（SMI）临界值为男性<52.4 cm/m，女性<38.5 cm/m。本综述的结果表明，肌肉减少症是接受原发性根治性治疗的HNC患者总生存的一个强有力的预后因素。肌肉减少症评估似乎是HNC人群中的一个良好预后标志物。未来的营养干预研究可能会集中于逆转已确定的肌肉减少症个体的肌肉流失并改善总体结局。
