Akina Tamaki1, Nauman F Manzoor1, Eric Babajanian1, Mustafa Ascha2, Rod Rezaee1, Chad A Zender1. 1. 1 Ear, Nose, and Throat Institute, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA. 2. 2 Center for Clinical Investigation, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA.
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/m2, P = .009). Eighty-five subjects had HPV-positive disease, and they had a higher BMI (28.2 vs 24.2 kg/m2, 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.
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/m2, P = .009). Eighty-five subjects had HPV-positive disease, and they had a higher BMI (28.2 vs 24.2 kg/m2, 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.
Entities:
Keywords:
head and neck cancer; human papillomavirus; oropharyngeal squamous cell carcinoma; sarcopenia
Authors: Aaron J Grossberg; Crosby D Rock; Jared Edwards; Abdallah S R Mohamed; Debra Ruzensky; Angela Currie; Patricia Rosemond; Jack Phan; G Brandon Gunn; Steven J Frank; William H Morrison; Adam S Garden; Clifton D Fuller; David I Rosenthal Journal: Radiother Oncol Date: 2021-03-15 Impact factor: 6.901
Authors: Alexander Joseph Jones; Vincent J Campiti; Mohamedkazim Alwani; Leah J Novinger; Brady Jay Tucker; Andrea Bonetto; Jessica A Yesensky; Michael W Sim; Michael G Moore; Avinash V Mantravadi Journal: Laryngoscope Investig Otolaryngol Date: 2021-01-31