Clinical Significance of Sarcopenia among Patients with Advanced Oropharyngeal Cancer. (March 2019)

• Record Type: Journal Article
• Authors: Tamaki, Akina; Manzoor, Nauman F.; Babajanian, Eric; Ascha, Mustafa; Rezaee, Rod; Zender, Chad A.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 160:Number 3(2019)
• Page Start: 480
• Page End: 487
• Publication Date: 2019-03
• Subjects: head and neck cancer -- oropharyngeal squamous cell carcinoma -- sarcopenia -- human papillomavirus; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599818793857
• Languages: English
• ISSNs: 0194-5998

Abstract

Objectives: We investigated the prevalence and impact of sarcopenia on disease-free survival (DFS) and overall survival (OS) in advanced oropharyngeal cancer. Study Design: Retrospective study. Setting: Single-institution tertiary cancer care center. Subjects and Methods: We identified patients with advanced oropharyngeal cancer with pretreatment positron emission tomography–computed tomography scans for image analysis. Data were collected on the following variables: age, sex, smoking and alcohol status, stage (TNM and American Joint Committee on Cancer), human papillomavirus (HPV) status, body mass index (BMI), and treatment modality. Results: Of 113 patients identified with oropharyngeal cancer, 32 had sarcopenia: these patients were older (63.5 vs 57.6 years, P = .01), were less likely to be male (53.1% vs 76.5%, P = .03), and had a lower mean BMI (24.5 vs 28.4 kg/m 2, P = .009). Eighty-five subjects had HPV-positive disease, and they had a higher BMI (28.2 vs 24.2 kg/m 2, P = .01) than that of patients without HPV. Twenty-one subjects who were HPV positive had less cancer recurrence (24.7% vs 48.1%, P = .04) than that of their HPV-negative counterparts. Log-rank testing showed no difference in DFS ( P = .06) associated with sarcopenia but a significant difference in OS ( P = .049). There were differences in DFS ( P = .009) and OS ( P = .023) based on HPV status. According to univariable and multivariable models, HPV positivity exhibited improved DFS and OS. Sarcopenia was not statistically significant in survival models; however, it was associated with increased mortality and recurrence. Conclusion: Sarcopenia is a prognostic factor affecting OS independent of HPV status in advanced oropharyngeal cancer.