Clinical Impact of Cachexia in Head and Neck Cancer Patients Who Received Chemoradiotherapy

Hayashi, Nobuyuki; Sato, Yasuyoshi; Fujiwara, Yu; Fukuda, N.; Wang, Xiaofei; Nakano, Kenji; Urasaki, Testuya; Ohmoto, Akihiro; Ono, Makiko; Tomomatsu, Junichi; Sato, Yukiko; Mitani, Hiroki; Toshiyasu, Takashi; Takahashi, Shunji

doi:10.2147/cmar.s329581

Cited by 11 publications

(10 citation statements)

References 31 publications

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“…Pre-existing sarcopenia was the only independent poor prognostic factor for OS, LRR, and DM for OCSCC that was never reported in previous studies. Although cancer cachexia is a well-known poor prognostic factor for survival in HNC [52,53], ours is the first study to establish pre-existing sarcopenia as an independent prognostic factor for OCSCC.…”

Section: Discussionmentioning

confidence: 81%

“…However, this definition precluded the differentiation of pre-existing sarcopenia from cancer cachexia-related sarcopenia [43]. This renders any results on the effect of sarcopenia unclear [43] and does not affect clinical practice in patients with HNC because cachexia is a well-known poor prognostic factor for OS in HNCs [52,53]. Our study is the first to present a clear definition of pre-existing sarcopenia (diagnosed ≥1 year before the diagnosis of OCSCC) in a homogenous group of patients with the same subtype of HNC (OCSCC) undergoing curative surgery.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Pre-Existing Sarcopenia on Oncological Outcomes for Oral Cavity Squamous Cell Carcinoma Undergoing Curative Surgery: A Propensity Score-Matched, Nationwide, Population-Based Cohort Study

Tsai

Chen

et al. 2022

Cancers

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Purpose: The effect of pre-existing sarcopenia on patients with oral cavity squamous cell carcinoma (OCSCC) remains unknown. Therefore, we designed a propensity score-matched population-based cohort study to compare the oncological outcomes of patients with OCSCC undergoing curative surgery with and without sarcopenia. Patients and Methods: We included patients with OCSCC undergoing curative surgery and categorized them into two groups according to the presence or absence of pre-existing sarcopenia. Patients in both the groups were matched at a ratio of 2:1. Results: The matching process yielded 16,294 patients (10,855 and 5439 without and with pre-existing sarcopenia, respectively). In multivariate Cox regression analyses, the adjusted hazard ratio (aHR, 95% confidence interval [CI]) of all-cause mortality for OCSCC with and without pre-existing sarcopenia was 1.15 (1.11–1.21, p < 0.0001). Furthermore, the aHRs (95% CIs) of locoregional recurrence and distant metastasis for OCSCC with and without pre-existing sarcopenia were 1.07 (1.03–1.18, p = 0.0020) and 1.07 (1.03–1.20, p = 0.0148), respectively. Conclusions: Pre-existing sarcopenia might be a significant poor prognostic factor for overall survival, locoregional recurrence, and distant metastasis for patients with OCSCC undergoing curative surgery. In susceptible patients at a risk of OCSCC, sarcopenia prevention measures should be encouraged, such as exercise and early nutrition intervention.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Effect of Pre-Existing Sarcopenia on Oncological Outcomes for Oral Cavity Squamous Cell Carcinoma Undergoing Curative Surgery: A Propensity Score-Matched, Nationwide, Population-Based Cohort Study

Tsai

Chen

et al. 2022

Cancers

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“…A study focusing on clinical impact of cachexia in patients with head and neck cancer undergoing chemoradiotherapy by Hayashi et al. ( 22 ) described that cachexia could play a negative role in all adverse events. Regarding grade 3/4 adverse events, a significant difference in the incidence of anemia, neutropenia, and leukopenia was observed between patients with and without cachexia.…”

Section: Discussionmentioning

confidence: 99%

“…More toxicities, treatment gaps, and postoperative complications 21) analyzed the short-term effect of cachexia on postoperative complications, and have reported that adverse events tended to occur in 64.3% of patients with cachexia, a rate that was significantly higher than that in those without cachexia. A study focusing on clinical impact of cachexia in patients with head and neck cancer undergoing chemoradiotherapy by Hayashi et al (22) described that cachexia could play a negative role in all adverse events. Regarding grade 3/4 adverse events, a significant difference in the incidence of anemia, neutropenia, and leukopenia was observed between patients with and without cachexia.…”

Section: Discussionmentioning

confidence: 99%

Predictors predisposing to orocutaneous fistula occurrence following free flap reconstruction

Yuan

et al. 2022

Front. Oncol.

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ObjectivesTo explore the possible risk factors of orocutaneous fistula (OCF) development in free flap reconstruction of the tongue/floor of the mouth (TFOM).MethodsData of patients who underwent free flap reconstruction of the TFOM were retrospectively analyzed. The association between clinicopathologic variables and OCF occurrence was analyzed using univariate and multivariate analyses.ResultsAltogether, 469 patients were enrolled. OCF occurred in 43 patients with a rate of 9.2%. The univariate analysis revealed the negative effects of smoking, preoperative albumin level, cachexia, T4 stage, neck dissection, entire resection of the floor of the mouth (FOM), segmental mandibulectomy, and surgical site infection on OCF occurrence. The multivariate analysis confirmed the independence of cachexia (p<0.001, 4.386[1.883–9.472]), tumor stage (p<0.001, 2.738[1.482–6.629]), entire FOM resection (p<0.001, 6.332[2.110–14.432]), and surgical site infection (p<0.001, 5.376[1.998–11.218]) in affecting the OCF development.ConclusionsOCF development following free flap reconstruction of the TFOM was relatively uncommon, but significantly associated with presence of cachexia, T4 stage, entire FOM resection, and surgical site infection.

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“…Hayashi et al. ( 23 ) enrolled 192 patients receiving chemoradiotherapy for head and neck cancer, and found that in a setting of chemoradiotherapy, all adverse events were strongly associated with cachexia. Among grade 3–4 adverse events, the frequency of leukopenia, anemia, and neutropenia had significant differences between patients with and without cachexia.…”

Section: Discussionmentioning

confidence: 99%

Orocutaneous Fistula Formation in Free Flap Reconstruction for Oral Squamous Cell Carcinoma

Fang

Yuan

et al. 2022

Front. Oncol.

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ObjectiveThe aim of this study is to identify the risk factors associated with orocutaneous fistula (OCF) formation after free flap reconstruction for oral squamous cell carcinoma (SCC).MethodsPatients undergoing free flap reconstruction for oral SCC were retrospectively enrolled. The relationship between clinicopathologic variables and OCF formation was analyzed by univariate and multivariate analyses.ResultsA total of 87 OCFs occurred in 856 patients. Univariate analysis revealed cachexia, tumor at the tongue/floor of the mouth (TFOM), T4 stage, preoperative hemoglobin level, pull-through procedure, preoperative albumin level, and surgical site infection were associated with the formation of OCF. Multivariate analysis confirmed the independence of cachexia, TFOM, T4 stage, and surgical site infection in predicting OCF development. Conventional wound care could achieve successful fistula closure in 82.4% of the patients with a median time of 28 days.ConclusionsOCF formation was common after free flap reconstruction. The presence of cachexia, TFOM tumor site, T4 stage, and surgical site infection significantly increased the risk of OCF formation. Although it required a long period, conventional wound care can obtain satisfactory outcomes in OCF management.

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Clinical Impact of Cachexia in Head and Neck Cancer Patients Who Received Chemoradiotherapy

Cited by 11 publications

References 31 publications

Effect of Pre-Existing Sarcopenia on Oncological Outcomes for Oral Cavity Squamous Cell Carcinoma Undergoing Curative Surgery: A Propensity Score-Matched, Nationwide, Population-Based Cohort Study

Effect of Pre-Existing Sarcopenia on Oncological Outcomes for Oral Cavity Squamous Cell Carcinoma Undergoing Curative Surgery: A Propensity Score-Matched, Nationwide, Population-Based Cohort Study

Predictors predisposing to orocutaneous fistula occurrence following free flap reconstruction

Orocutaneous Fistula Formation in Free Flap Reconstruction for Oral Squamous Cell Carcinoma

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