Retrospective analysis of skeletal muscle mass index (SMI) as a prognostic factor in head and neck carcinoma

Introduction The prognosis of cancer patients depends on various factors. A reduced skeletal muscle mass index (SMI) is a marker of poorer survival in cancer patients. SMI is usually determined at the third lumbar vertebra (L3) and in the cervical region at the 3rd cervical vertebra (C3) by computed tomography (CT). The measurement is not routinely performed in patients with head and neck squamous cell carcinoma (HNSCC). We retrospectively determined the SMI of cervical and abdominal CT scans in patients with hypopharyngeal and laryngeal carcinomas and used it to predict their overall survival.

Methods SMI was determined in 168 patients with laryngeal (UICC stage II-IV) and hypopharyngeal (UICC stage I-IV) carcinomas by measuring the cross-sectional area (CSA) of the muscles at the level of the cervical vertebra (C3). Lumbar SMI was calculated according to an established formula. Clinical data such as 5-year and overall survival, therapies performed, ECOG performance status, BMI, and laboratory values at diagnosis were collected.

Results Data to date show a correlation between BMI and overall survival, but no significant correlation between cervical SMI and overall survival, but between lumbar SMI and overall survival.

Conclusion Sarcopenia is associated with poorer overall survival in HNSCC patient*ins. Therefore, this aspect should be strongly considered in clinical decision making.

Publication History

Article published online:
12 May 2023