Diagnosis of Sarcopenia in Head and Neck Computed Tomography: Cervical Muscle Mass as a Strong Indicator of Sarcopenia

Ufuk, Furkan; Herek, Duygu; Yüksel, Doğangün

doi:10.21053/ceo.2018.01613

Cited by 49 publications

(52 citation statements)

References 21 publications

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“…the masseter and pterygoid muscles, in accord with the findings of previous studies [29,30]. Multivariate analyses further revealed that an M-SMI of <5.5 and age of �75 years are independent predictors of sarcopenia.…”

Section: Plos Onesupporting

confidence: 89%

Masticatory muscle index for indicating skeletal muscle mass in patients with head and neck cancer

et al. 2021

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Background A typical assessment for sarcopenia involves the use of abdominal computed tomography (CT) for calculating the skeletal muscle index (SMI) at the level of the third lumbar vertebra (L3). However, abdominal CT is not regularly performed on patients with head and neck cancer (HNC). We investigated whether masticatory SMI (M-SMI) measurements based on head and neck CT scans can be used to conduct sarcopenia assessments by evaluating whether M-SMI is correlated with L3-SMI. Methods Abdominal and head and neck CT images of patients with trauma (n = 50) and HNC (n = 52) were analyzed retrospectively. Both manual delineation and threshold selection methods were used to measure cross-sectional areas of masticatory muscles and those of muscles at the L3 level on CT images. Muscle cross-sectional areas were normalized to height squared to calculate SMI, and a multivariate linear regression model was established to evaluate the correlation between the M-SMI and L3-SMI. Receiver operating characteristic curve analysis was used to assess the ability of the M-SMI to identify sarcopenia, and Cox logistic regression was used to identify predictors of sarcopenia. Results Patients with HNC had significantly lower M-SMI and L3-SMI than did patients with trauma (p = 0.011 and 0.03, respectively). M-SMI and L3-SMI were strongly correlated (r = 0.901, p < 0.001); in the multivariate model that included sex, the correlation was stronger (r = 0.913, p < 0.001). The associations of sarcopenia with a lower M-SMI (p < 0.001), male sex (p = 0.028), and advanced age (p = 0.011) were significant, and multivariate logistic analysis demonstrated that an M-SMI of <5.5 was an independent predictor of sarcopenia (hazard ratio = 5.37, p < 0.001). Conclusions M-SMI assessment in routine head and neck CT scans is feasible and can be an alternative for detecting sarcopenia in patients with HNC.

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Section: Plos Onesupporting

confidence: 89%

Masticatory muscle index for indicating skeletal muscle mass in patients with head and neck cancer

et al. 2021

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“…This measurement method has been validated in studies using whole body MRI (121), appears to be also applicable on MRI of the head and neck (122) and has a high interobserver and intraobserver agreement (123, 124). Also others found measurement of skeletal muscle area at level C3 a good alternative for measurement at level L3 (125).…”

Section: Emerging Biomarkersmentioning

confidence: 99%

Diagnostic Tumor Markers in Head and Neck Squamous Cell Carcinoma (HNSCC) in the Clinical Setting

et al. 2019

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Head and neck squamous cell carcinoma (HNSCC) represents a group of tumors arising in the oral cavity, oropharynx, and larynx. Although HNSCC is traditionally associated with tobacco and alcohol consumption, a growing proportion of head and neck tumors, mainly of the oropharynx, are associated with Human Papilloma Virus (HPV). Recurrent/metastatic disease is characterized by dismal prognosis and there is an unmet need for the development of biomarkers for detection of early disease, accurate prediction of prognosis, and appropriate selection of therapy. Based on the REMARK guidelines, a variety of diagnostic and prognostic biomarkers are being evaluated in clinical trials but their clinical significance is doubtful. Herein, we will focus on biomarkers in HNSCC used in the clinical setting and we will illustrate their clinical relevance.

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“…As abdominal CT scans were generally unavailable for patients with OSCC, it posed a limitation in the applicability of assessing sarcopenia by evaluating at the L3 level. However, recently, skeletal muscle measurement methods at the C3 vertebral level have been developed, which could be used for this study population 20–22 . The assessment of skeletal muscle with routinely available CT scans might be a promising, feasible, and cost‐effective imaging biomarker to predict outcomes in OSCC patients.…”

Section: Introductionmentioning

confidence: 99%

Sarcopenia and Systemic Inflammation Synergistically Impact Survival in Oral Cavity Cancer

et al. 2020

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Objectives Sarcopenia and systemic inflammation can affect survival of advanced‐stage oral squamous cell carcinoma (OSCC) patients; however, their reciprocal associations with survival outcomes are yet to be investigated. Study Design Retrospective review at a tertiary cancer center. Methods Patients with stage III‐IVB OSCC that underwent surgery and (chemo)radiotherapy at our institution between 2010 and 2015 were reviewed. Skeletal muscle index (SMI) was assessed using computed tomography scans at the C3 vertebra. Sarcopenia was defined at the lowest sex‐specific tertile for SMI. Systemic inflammation was estimated using the modified Glasgow prognostic score (mGPS), which ranges from 0 to 2 based on serum C‐reactive protein and albumin levels. The predictors of overall survival (OS) were evaluated using Cox regression models. Results A total of 174 patients were included in the study. The cut‐off values for sarcopenia were set at SMI <52.4 cm2/m2 (men) and < 36.2 cm2/m2 (women) corresponding to the lowest sex‐specific tertile. An mGPS 1–2 was independently associated with sarcopenia (odds ratio: 2.05; 95% confidence interval: 1.06–3.97; P = .03). On multivariate analysis for OS, sarcopenia and mGPS 1–2 independently predicted OS (hazard ratio: 2.12; 95% confidence interval: 1.17–3.85; P = .01 and hazard ratio: 7.85; 95% confidence interval: 3.7–16.65; P < .001, respectively). Patients with both sarcopenia and mGPS 1–2 (vs. neither) had worse OS (hazard ratio: 16.80; 95% confidence interval: 6.01–46.99; P < .001). Conclusions Sarcopenia and systemic inflammation may exert a negative synergistic prognostic impact in advanced‐stage OSCC patients. Level of Evidence 4 Laryngoscope, 131:E1530–E1538, 2021

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Diagnosis of Sarcopenia in Head and Neck Computed Tomography: Cervical Muscle Mass as a Strong Indicator of Sarcopenia

Cited by 49 publications

References 21 publications

Masticatory muscle index for indicating skeletal muscle mass in patients with head and neck cancer

Masticatory muscle index for indicating skeletal muscle mass in patients with head and neck cancer

Diagnostic Tumor Markers in Head and Neck Squamous Cell Carcinoma (HNSCC) in the Clinical Setting

Sarcopenia and Systemic Inflammation Synergistically Impact Survival in Oral Cavity Cancer

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