Prognostische Rolle der Skelettmuskulatur bei Plattenepithelkarzinomen der Kopf-Hals-Region

Zusammenfassung

Sarkopenie ist definiert als Verlust von Muskelmasse und -kraft sowie als Abnahme der körperlichen Leistungsfähigkeit. Die vorliegende Arbeit gibt einen systematischen Überblick über die aktuelle Literatur zur prognostischen Rolle der Sarkopenie bei Patienten mit Plattenepithelkarzinom des Kopfes und Halses (HNSCC). Sarkopenie tritt in 42% der Fälle von HNSCC auf. Sarkopenie ist mit dem Auftreten postoperativer Komplikationen verbunden. Auch eine reduzierte Muskelmasse schränkt das krankheitsfreie und das Gesamtüberleben ein. Daher sollte die Analyse der Skelettmuskulatur im Staging-CT in die klinische Routine bei Patienten mit HNSCC aufgenommen werden.

Abstract

Sarcopenia is defined as loss of muscle mass and strength as well as decreased physical performance. The present work gives a systematic overview of the current literature about the prognostic role of sarcopenia in patients with head and neck squamous cell carcinoma (HNSCC). Sarcopenia occurs in 42 % in HNSCC. Sarcopenia is associated with occurrence of postoperative complications. Also reduced muscle mass limits disease-free and overall survival. Therefore, analysis of the skeletal musculature on staging CT should be implemented into the clinical routine in patients with HNSCC.

Schlüsselwörter

Sarkopenie - Überleben - postoperative Komplikationen - Plattenepithelkarzinom - Kopf-Halsregion

Keywords

Sarcopenia - squamous cell carcinoma - head and neck region - postoperative complications - survival

Publikationsverlauf

Eingereicht: 16. Mai 2025

Angenommen nach Revision: 28. Juli 2025

Artikel online veröffentlicht:
04. September 2025

• Literatur

• 1 Cruz-Jentoft AJ, Bahat G, Bauer J. et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019; 48: 16-31
• 2 Kamarajah SK, Bundred J, Tan BHL. Body composition assessment and sarcopenia in patients with gastric cancer: a systematic review and meta-analysis. Gastric Cancer 2019; 22: 10-22
• 3 Aleixo GFP, Williams GR, Nyrop KA. et al. Muscle composition and outcomes in patients with breast cancer: meta-analysis and systematic review. Breast Cancer Res Treat 2019; 177: 569-579
• 4 Surov A, Wienke A. Sarcopenia predicts overall survival in patients with malignant hematological diseases: A meta-analysis. Clin Nutr 2021; 40: 1155-1160
• 5 Kyle UG, Bosaeus I, De Lorenzo AD. et al. Bioelectrical impedance analysis--part I: review of principles and methods. Clin Nutr 2004; 23: 1226-1243
• 6 Messina C, Maffi G, Vitale JA. et al. Diagnostic imaging of osteoporosis and sarcopenia: a narrative review. Quant Imaging Med Surg 2018; 8: 86-99
• 7 Elhabash S, Langhammer N, Fetzner UK. et al. Prognostic value of body composition in oncological visceral surgery. Chirurgie (Heidelb) 2025; 96: 213-221
• 8 Surov A, Wienke A, Gutzmer R. et al. Time to include sarcopenia into the oncological routine. Eur J Cancer 2023; 190: 112939
• 9 Surov A, Pech M, Gessner D. et al. Low skeletal muscle mass is a predictor of treatment related toxicity in oncologic patients. A meta-analysis. Clin Nutr 2021; 40: 5298-5310
• 10 Surov A, Strobel A, Borggrefe J. et al. Low skeletal muscle mass predicts treatment response in oncology: a meta-analysis. Eur Radiol 2023; 33: 6426-6437
• 11 Bril SI, van Beers MA, Chargi N. et al. Skeletal muscle mass at C3 is a strong predictor for skeletal muscle mass at L3 in sarcopenic and non-sarcopenic patients with head and neck cancer. Oral Oncol 2021; 122: 105558
• 12 Chargi N, Bril SI, Smid EJ. et al. Cut-off values for low skeletal muscle mass at the level of the third cervical vertebra (C3) in patients with head and neck cancer. Quant Imaging Med Surg 2022; 12: 3024-3033
• 13 Bril SI, Chargi N, Wendrich AW. et al. Validation of skeletal muscle mass assessment at the level of the third cervical vertebra in patients with head and neck cancer. Oral Oncol 2021; 123: 105617
• 14 Kreher R, Hille G, Preim B. et al. Multilabel segmentation and analysis of skeletal muscle and adipose tissue in routine abdominal CT scans. Comput Biol Med 2025; 186: 109622
• 15 Haubold J, Baldini G, Parmar V. et al. BOA: A CT-Based Body and Organ Analysis for Radiologists at the Point of Care. Invest Radiol 2024; 59: 433-441
• 16 Findlay M, White K, Stapleton N. et al. Is sarcopenia a predictor of prognosis for patients undergoing radiotherapy for head and neck cancer? A meta-analysis. Clin Nutr 2021; 40: 1711-1718
• 17 Surov A, Wienke A. Low skeletal muscle mass predicts relevant clinical outcomes in head and neck squamous cell carcinoma. A meta analysis. Ther Adv Med Oncol 2021; 13: 17588359211008844
• 18 Yang D, Su L, Zhang L. et al. Sarcopenia predicts postoperative complications in head and neck cancer: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2024; 281: 3959-3975
• 19 Koh JH, Lim CYJ, Tan LTP. et al. Prevalence and Association of Sarcopenia with Mortality in Patients with Head and Neck Cancer: A Systematic Review and Meta-Analysis. Ann Surg Oncol 2024; 31: 6049-6064
• 20 Chargi N, Molenaar-Kuijsten L, Huiskamp LFJ. et al. The association of cisplatin pharmacokinetics and skeletal muscle mass in patients with head and neck cancer: The prospective PLATISMA study. Eur J Cancer 2022; 160: 92-99
• 21 Park S-Y, Hwang B-O, Song N-Y. The role of myokines in cancer: crosstalk between skeletal muscle and tumor. BMB Rep 2023; 56: 365-373
• 22 Kabarriti R, Bontempo A, Romano M. et al. The impact of dietary regimen compliance on outcomes for HNSCC patients treated with radiation therapy. Support Care Cancer 2018; 26: 3307-3313
• 23 Cederholm T, Jensen GL, Correia MITD. et al. GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community. Clin Nutr 2019; 38: 1-9