CT-measured skeletal muscle mass used to assess frailty in patients with head and neck cancer

Autor: Peter M. A. van Ooijen, Anouk van der Hoorn, Roel J H M Steenbakkers, Aniek T Zwart, Gyorgy B. Halmos, Geertruida H. de Bock
Přispěvatelé: Guided Treatment in Optimal Selected Cancer Patients (GUTS), Damage and Repair in Cancer Development and Cancer Treatment (DARE), Life Course Epidemiology (LCE), ​Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE)
Jazyk: angličtina
Rok vydání: 2019
Předmět:
0301 basic medicine
Male
medicine.medical_specialty
Sarcopenia
Computer‐assisted image analysis
lcsh:Diseases of the musculoskeletal system
Frail Elderly
Timed Up and Go test
Logistic regression
Head and neck neoplasms
lcsh:QM1-695
03 medical and health sciences
0302 clinical medicine
Physiology (medical)
Internal medicine
medicine
Humans
Orthopedics and Sports Medicine
Body Weights and Measures
Muscle
Skeletal
Exercise
Aged
Geriatrics
Frailty
business.industry
Malnutrition
Reproducibility of Results
Odds ratio
Organ Size
Original Articles
lcsh:Human anatomy
Middle Aged
medicine.disease
Mobility limitation
Confidence interval
030104 developmental biology
Cross-Sectional Studies
030220 oncology & carcinogenesis
Cohort
Biomarker (medicine)
Female
Original Article
lcsh:RC925-935
business
Tomography
X-Ray Computed
Zdroj: Journal of cachexia sarcopenia and muscle, 10(5), 1060-1069. Wiley
Journal of Cachexia, Sarcopenia and Muscle, Vol 10, Iss 5, Pp 1060-1069 (2019)
Journal of Cachexia, Sarcopenia and Muscle
ISSN: 2190-6009
Popis: BACKGROUND: Skeletal muscle depletion or sarcopenia is related to multiple adverse clinical outcome. However, frailty questionnaires are currently applied in the daily practice to identify patients who are potentially (un)suitable for treatment but are time consuming and straining for patients and the clinician. Screening for sarcopenia in patients with head and neck cancer (HNC) could be a promising fast biomarker for frailty. Our objective was to quantify sarcopenia with pre-treatment low skeletal muscle mass from routinely obtained neck computed tomography scans at level of third cervical vertebra in patients diagnosed with HNC and evaluate its association with frailty.METHODS: A total of 112 HNC patients with Stages III and IV disease were included from a prospective databiobank. The amount of skeletal muscle mass was retrospectively defined using the skeletal muscle index (SMI). Correlation analysis between SMI and continuous frailty data and the observer agreement were analysed with Pearson's r correlation coefficients. Sarcopenia was present when SMI felt below previously published non-gender specific thresholds (RESULTS: The cohort included 82 men (73%) and 30 women (27%), with a total mean age of 63 (±9) years. The observer agreement for cross-sectional measurements was excellent for both intra-observer variability (r = 0.99, P < 0.001) and inter-observer variability (r = 0.98, P < 0.001). SMI correlated best with G8 frailty score (r = 0.38, P < 0.001) and did not differ per gender. Sarcopenia was present in 54 (48%) patients, whereof 25 (46%) men and 29 (54%) women. Prevalence of frailty was between 5% and 54% depending on the used screening tool. The multivariate regression analysis for all patients and men separately isolated the G8 questionnaire as the only independent variable associated with sarcopenia (OR 0.76, 95% CI 0.66-0.89, P < 0.001 and OR 0.76, 95% CI 0.66-0.88, P < 0.001, respectively).CONCLUSIONS: This is the first study that demonstrates that sarcopenia is independently associated with frailty based on the G8 questionnaire in HNC patients. These results suggest that in the future, screening for sarcopenia on routinely obtained neck computed tomography scans may replace time consuming frailty questionnaires and help to select the (un)suitable patients for therapy, which is highly clinically relevant.
Databáze: OpenAIRE
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