Low skeletal muscle mass is a strong predictive factor for surgical complications and a prognostic factor in oral cancer patients undergoing mandibular reconstruction with a free fibula flap

Ansari, Ejaz; Chargi, Najiba; Gemert, Johannes T.M. van; Es, Robert J.J. van; Dieleman, F.J.; Rosenberg, Antoine J.W.P.; Cann, Ellen M. Van; Bree, Remco de

doi:10.1016/j.oraloncology.2019.104530

Cited by 51 publications

(71 citation statements)

References 42 publications

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“…This prognostic value of LSMM has been demonstrated in a variety of cancer types including lung [3], colorectal [5], breast [6], renal [7], and head and neck cancer [8]. LSMM has also been investigated as a predictive factor for adverse events such as chemotherapy toxicity, surgical complications, and radiotherapy toxicity [5][6][7]9,10].…”

Section: Introductionmentioning

confidence: 98%

The Predictive Value of Low Skeletal Muscle Mass Assessed on Cross-Sectional Imaging for Anti-Cancer Drug Toxicity: A Systematic Review and Meta-Analysis

Huiskamp

Chargi

Devriese

et al. 2020

JCM

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Low skeletal muscle mass (LSMM) is increasingly recognized for its predictive value for adverse events in cancer patients. In specific, the predictive value of LSMM has been demonstrated for anti-cancer drug toxicity in a variety of cancer types and anti-cancer drugs. However, due to the limited sample size and study populations focused on a single cancer type, an overall predictive value of LSMM for anti-cancer drug toxicity remains unknown. Therefore, this review aims to provide a comprehensive overview of the predictive value of LSMM and perform a meta-analysis to analyse the overall effect. A systematic search was conducted of MEDLINE, Scopus, EMBASE, and Cochrane. Inclusion criteria were skeletal muscle mass (SMM) evaluated with computed tomography (CT) or magnetic resonance imaging (MRI), articles published in English, SMM studied in humans, SMM measurement normalized for height, and patients did not receive an intervention to treat or prevent LSMM. A meta-analysis was performed using a random-effects model and expressed in odds ratio (OR) with 95% confidence interval (CI). Heterogeneity was assessed using χ2 and I2 statistics. The search yielded 907 studies. 31 studies were included in the systematic review. Sample sizes ranged from 21 to 414 patients. The occurrence of LSMM ranged from 12.2% to 89.0%. The most frequently studied cancer types were oesophageal, renal, colorectal, breast, and head and neck cancer. Patients with LSMM had a higher risk of severe toxicity (OR 4.08; 95% CI 2.48–6.70; p < 0.001) and dose-limiting toxicity (OR 2.24; 95% CI 1.28–3.92; p < 0.001) compared to patients without LSMM. To conclude, the predictive value of LSMM for anti-cancer drug toxicity can be observed across cancer types. This information increases the need for further research into interventions that could treat LSMM as well as the possibility to adapt treatment regimens based on the presence of LSMM.

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Section: Introductionmentioning

confidence: 98%

The Predictive Value of Low Skeletal Muscle Mass Assessed on Cross-Sectional Imaging for Anti-Cancer Drug Toxicity: A Systematic Review and Meta-Analysis

Huiskamp

Chargi

Devriese

et al. 2020

JCM

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“…Furthermore, the patient's postoperative survival likelihood should be considered before this procedure is selected. However, to the best of our knowledge, only one article apart from this current study has reported on the impact of SMM on survival after free flap reconstruction (Ansari et al, 2020). Furthermore, oral cancer patients who need free flap reconstruction tend to have advanced tumors and low SMM owing to malnutrition caused by dysphagia.…”

Section: Introductionmentioning

confidence: 70%

“…Recently, some reports have demonstrated the association between low SMM and negative outcomes, such as increased postoperative complications, chemotherapy toxicity, and decreased survival rates in a variety of cancer resection surgeries (Ansari et al, 2020; Caan et al, 2018; Chargi, Bril, Emmelot‐Vonk, & de Bree, 2019; Cho et al, 2018; Fattouh et al, 2019; Ganju, Morse, Hoover, TenNapel, & Lominska, 2019; Harimoto et al, 2013; Makiguchi et al, 2019; Nakamura et al, 2020; Nakamura et al, 2020; Tamaki et al, 2019; Wendrich et al, 2017; Yamamoto et al, 2017). Furthermore, a few previous reports showed that preoperative exercise and nutrition support programs could be beneficial in patients with sarcopenia (Huang et al, 2017; Pedersen et al, 2016; Staron et al, 1994).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of overall and disease‐free survival in patients with free flaps for oral cancer resection

et al. 2020

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Purpose Sarcopenia is characterized by depletion of skeletal muscle mass (SMM) and can cause increased postoperative complication in free flap procedure. One of the most important considerations while deciding the indication of the procedure is patients' survival. This study aimed to verify the relationship between low SMM and survival in patients who undergo oral cancer resection using free flap. Methods SMM was evaluated using the skeletal muscle index (SMI cm2/m2), which was defined using cross‐sectional areas of skeletal muscles on computed tomography at the level of the third lumbar vertebrae normalized for height. Overall, 111 patients who underwent primary oral cancer resection and free flaps were included. Multivariate Cox regression analyses were used to evaluate the prognostic factors for survival. Results A total of 25 patients (22.5%) were diagnosed with low SMM. The mean SMI was 42.2 cm2/m2. Multivariable analyses showed that increased age (hazard ratio [HR]; 4.98, p = .004), infiltrative growth pattern INF‐c (HR; 3.83, p = .037), and low SMM (HR; 2.59, p = .034) were significant negative prognostic factors for overall survival. Increased age (HR; 3.18, p = .005), extra‐nodal extension (HR; 3.30, p = .001), and low SMM (HR; 2.42, p = .017) were significant negative prognostic factors for disease‐free survival. Conclusions Low SMM is a significant negative prognostic factor for overall and disease‐free survival in oral cancer patients undergoing free flap. Future prospective studies are warranted to identify effective preoperative exercise and nutrition programs to improve low skeletal muscle and survival rate in patients undergoing free flap procedures.

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“…With the development of modern medicine, significant progress has been made in the reconstruction of mandibular defects. At present, there are a variety of repair methods, including commercial reconstruction titanium plates (for example the Stryker Leibinger universal system), non-vascularized autogenous bone grafts, pedicled bone grafts and vascularized fibula free grafts (27,28); however, the existing repair methods often do not perfectly restore the continuity and integrity of the mandible, which may result in a second trauma (29). Using digital medical imaging technology and metal 3D printing technology, according to CT scan data of patients, porous titanium alloy bone tissue substitute materials that are similar in shape, size and weight to the bone defect area can be designed and manufactured to achieve personalized repair and reconstruction of bone defects (30).…”

Section: Application Of Additive Manufacturing In Customized Titaniummentioning

confidence: 99%

Application of additive manufacturing in customized titanium mandibular implants for patients with oral tumors

Xia

Feng

et al. 2020

Oncol Lett

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Low skeletal muscle mass is a strong predictive factor for surgical complications and a prognostic factor in oral cancer patients undergoing mandibular reconstruction with a free fibula flap

Cited by 51 publications

References 42 publications

The Predictive Value of Low Skeletal Muscle Mass Assessed on Cross-Sectional Imaging for Anti-Cancer Drug Toxicity: A Systematic Review and Meta-Analysis

The Predictive Value of Low Skeletal Muscle Mass Assessed on Cross-Sectional Imaging for Anti-Cancer Drug Toxicity: A Systematic Review and Meta-Analysis

Evaluation of overall and disease‐free survival in patients with free flaps for oral cancer resection

Application of additive manufacturing in customized titanium mandibular implants for patients with oral tumors

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