Preoperative low skeletal muscle mass as a risk factor for pharyngocutaneous fistula and decreased overall survival in patients undergoing total laryngectomy

Abstract Purpose Skeletal muscle mass (SMM) loss and sarcopenia have been identified as risk factors for postoperative complications. The aim of this study was to investigate the relationship between pharyngocutaneous fistula (PCF) formation after total laryngectomy (TL) and SMM assessed from a computed tomography image of the 3rd cervical vertebra (C3). Methods Retrospective study of 86 male patients who underwent TL between 2013 and 2019 in a single institution. We excluded women from the analysis due to our limited sample. SMM was determined from cross-sectional muscle area (CSMA) measurement at C3 using the ImageJ software. Results were compared with those for the skeletal muscle mass index (SMMI) calculated from the estimated measure at 3rd lumbar vertebra (L3). Results PCF formation occurred in 21/86 patients. According to the CSMA at a C3 cut-off of 35.5cm2, of 18 patients (20.9%) with low SMM, 9 developed PCFs (50.0%). Among patients with normal SMM (n = 68, 79.1%), 12 developed PCFs (17.6%). The CSMA at C3 was the only variable significantly associated with PCF risk, which was 4.7 times greater in patients with low SMM (p = 0.007). Sarcopenia was more frequent in underweight patients (p = 0.0001), patients undergoing extended surgeries (p = 0.003), or presenting preoperative anaemia (p = 0.009) or hypoalbuminemia (p = 0.027). Conclusion Measuring the CSMA at C3 obtained results equivalent to those obtained by calculating the SMMI at L3, suggesting that direct SMM assessment from C3 is a useful approach to evaluating PCF formation risk after TL.

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The BMI and skeletal muscle mass as a risk factor of carotid atherosclerosis in patients with type 2 diabetes

Endocrine Abstracts ◽

10.1530/endoabs.56.gp73 ◽

2018 ◽

Author(s):

Se-Hwa Kim ◽

Soo-Kyung Kim ◽

Young-Ju Choi ◽

Seok-Won Park ◽

Eun-Jig Lee ◽

...

Keyword(s):

Type 2 Diabetes ◽

Skeletal Muscle ◽

Risk Factor ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Carotid Atherosclerosis

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Relationship between Muscle Mass and Non-Alcoholic Fatty Liver Disease

Biology ◽

10.3390/biology10020122 ◽

2021 ◽

Vol 10 (2) ◽

pp. 122

Author(s):

Jun-Hyuk Lee ◽

Hye-Sun Lee ◽

Byoung-Kwon Lee ◽

Yu-Jin Kwon ◽

Ji-Won Lee

Keyword(s):

Skeletal Muscle ◽

Risk Factor ◽

Liver Disease ◽

Fatty Liver ◽

Muscle Mass ◽

Fatty Liver Disease ◽

Skeletal Muscle Mass ◽

Liver Fat ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

Although sarcopenia is known to be a risk factor for non-alcoholic fatty liver disease (NAFLD), whether NAFLD is a risk factor for the development of sarcopenia is not clear. We investigated relationships between NAFLD and low skeletal muscle mass index (LSMI) using three different datasets. Participants were classified into LSMI and normal groups. LSMI was defined as a body mass index (BMI)-adjusted appendicular skeletal muscle mass <0.789 in men and <0.512 in women or as the sex-specific lowest quintile of BMI-adjusted total skeletal muscle mass. NAFLD was determined according to NAFLD liver fat score or abdominal ultrasonography. The NAFLD groups showed a higher hazard ratios (HRs) with 95% confidence intervals (CIs) for LSMI than the normal groups (HRs = 1.21, 95% CIs = 1.05–1.40). The LSMI groups also showed a higher HRs with 95% CIs for NAFLD than normal groups (HRs = 1.56, 95% CIs = 1.38–1.78). Participants with NAFLD had consistently less skeletal muscle mass over 12 years of follow-up. In conclusion, LSMI and NAFLD showed a relationship. Maintaining muscle mass should be emphasized in the management of NAFLD.

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Low Skeletal Muscle Mass Is An Independent Risk Factor For Arterial Stiffness: The Nagahama Study

Atherosclerosis ◽

10.1016/j.atherosclerosis.2019.06.092 ◽

2019 ◽

Vol 287 ◽

pp. e31

Author(s):

Y. Tabara ◽

K. Setoh ◽

T. Nakayama ◽

F. Matsuda

Keyword(s):

Skeletal Muscle ◽

Risk Factor ◽

Arterial Stiffness ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Independent Risk Factor

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Low Skeletal Muscle Mass Is a Risk Factor for Aspiration Pneumonia During Chemoradiotherapy

The Laryngoscope ◽

10.1002/lary.29165 ◽

2020 ◽

Author(s):

Kazuhira Endo ◽

Takayoshi Ueno ◽

Nobuyuki Hirai ◽

Takeshi Komori ◽

Yosuke Nakanishi ◽

...

Keyword(s):

Skeletal Muscle ◽

Risk Factor ◽

Muscle Mass ◽

Aspiration Pneumonia ◽

Skeletal Muscle Mass

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The Combination of Low Skeletal Muscle Mass and High Tumor Interleukin-6 Associates with Decreased Survival in Clear Cell Renal Cell Carcinoma

Cancers ◽

10.3390/cancers12061605 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1605

Author(s):

Joshua K. Kays ◽

Leonidas G. Koniaris ◽

Caleb A. Cooper ◽

Roberto Pili ◽

Guanglong Jiang ◽

...

Keyword(s):

Gene Expression ◽

Skeletal Muscle ◽

Overall Survival ◽

Muscle Mass ◽

Interleukin 6 ◽

Skeletal Muscle Mass ◽

Clear Cell ◽

Cytokine Gene Expression ◽

Ct Scans ◽

Adipose Mass

Clear cell renal carcinoma (ccRCC) is frequently associated with cachexia which is itself associated with decreased survival and quality of life. We examined relationships among body phenotype, tumor gene expression, and survival. Demographic, clinical, computed tomography (CT) scans and tumor RNASeq for 217 ccRCC patients were acquired from the Cancer Imaging Archive and The Cancer Genome Atlas (TCGA). Skeletal muscle and fat masses measured from CT scans and tumor cytokine gene expression were compared with survival by univariate and multivariate analysis. Patients in the lowest skeletal muscle mass (SKM) quartile had significantly shorter overall survival versus the top three SKM quartiles. Patients who fell into the lowest quartiles for visceral adipose mass (VAT) and subcutaneous adipose mass (SCAT) also demonstrated significantly shorter overall survival. Multiple tumor cytokines correlated with mortality, most strongly interleukin-6 (IL-6); high IL-6 expression was associated with significantly decreased survival. The combination of low SKM/high IL-6 was associated with significantly lower overall survival compared to high SKM/low IL-6 expression (26.1 months vs. not reached; p < 0.001) and an increased risk of mortality (HR = 5.95; 95% CI = 2.86–12.38). In conclusion, tumor cytokine expression, body composition, and survival are closely related, with low SKM/high IL-6 expression portending worse prognosis in ccRCC.

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In Response to Low Skeletal Muscle Mass Is a Risk Factor for Aspiration Pneumonia

The Laryngoscope ◽

10.1002/lary.29792 ◽

2021 ◽

Author(s):

Kazuhira Endo ◽

Takayoshi Ueno ◽

Nobuyuki Hirai ◽

Takeshi Komori ◽

Yosuke Nakanishi ◽

...

Keyword(s):

Skeletal Muscle ◽

Risk Factor ◽

Muscle Mass ◽

Aspiration Pneumonia ◽

Skeletal Muscle Mass

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Prognostic value of low skeletal muscle mass in patient treated by exclusive curative radiochemotherapy for a NSCLC

Scientific Reports ◽

10.1038/s41598-021-90187-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

R. Mallet ◽

P. Decazes ◽

R. Modzelewski ◽

J. Lequesne ◽

P. Vera ◽

...

Keyword(s):

Skeletal Muscle ◽

Overall Survival ◽

Prognostic Factor ◽

Muscle Mass ◽

Body Mass ◽

Visceral Fat ◽

Prognostic Value ◽

Skeletal Muscle Mass ◽

Pet Ct ◽

Cox Analysis

AbstractLow skeletal muscle mass is a well-known prognostic factor for patients treated for a non-small-cell lung cancer by surgery or chemotherapy. However, its impact in patients treated by exclusive radiochemotherapy has never been explored. Our study tries to evaluate the prognostic value of low skeletal muscle mass and other antropometric parameters on this population. Clinical, nutritional and anthropometric date were collected for 93 patients treated by radiochemotherapy for a NSCLC. Anthropometric parameters were measured on the PET/CT by two methods. The first method was a manual segmentation at level L3, used to define Muscle Body Area (MBAL3), Visceral Fat Area (VFAL3) and Subcutaneous Fat Area (SCFAL3). The second method was an software (Anthropometer3D), allowing an automatic multislice measurement of Lean Body Mass (LBMAnthro3D), Fat Body Mass (FBMAnthro3D), Muscle Body Mass (MBMAnthro3D), Visceral Fat Mass (VFMAnthro3D), and Sub-Cutaneous Fat Mass (SCFMAnthro3D) on the PET/CT. All anthropometrics parameters were normalised by the patient's height. The primary end point was overall survival time. Univariate and then stepwise multivariate cox analysis were performed for significant parameters. Finally, Spearman's correlation between MBAL3 and MBMAnthro3D was assessed. Forty-one (44%) patients had low skeletal muscle mass. The median overall survival was 18 months for low skeletal muscle mass patients versus 36 months for non-low skeletal muscle mass patients (p = 0.019). Low skeletal muscle mass (HR = 1.806, IC95% [1.09–2.98]), serums albumin level < 35 g/l (HR = 2.203 [1.19–4.09]), Buzby Index < 97.5 (HR = 2.31 [1.23–4.33]), WHO score = 0 (HR = 0.59 [0.31–0.86] and MBMAnthro3D < 8.56 kg/m2 (HR = 2.36 [1.41–3.90]) were the only significant features in univariates analysis. In the stepwise multivariate Cox analysis, only MBMAnthro3D < 8.56 kg/m2 (HR = 2.16, p = 0.003) and WHO score = 0 (HR = 0.59, p = 0.04) were significant. Finally, muscle quantified by MBAL3 and MBMAnthro3D were found to be highly correlated (Spearman = 0.9). Low skeletal muscle mass, assessed on the pre-treatment PET/CT is a powerful prognostic factor in patient treated by radiochemotherapy for a NSCLC. The automatic software Anthropometer3D can easily identify patients a risk that could benefit an adapted therapy.

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The predictive and prognostic value of low skeletal muscle mass for dose-limiting toxicity and survival in head and neck cancer patients receiving concomitant cetuximab and radiotherapy

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-020-05972-2 ◽

2020 ◽

Vol 277 (10) ◽

pp. 2847-2858 ◽

Cited By ~ 1

Author(s):

L. F. J. Huiskamp ◽

N. Chargi ◽

L. A. Devriese ◽

P. A. de Jong ◽

R. de Bree

Keyword(s):

Skeletal Muscle ◽

Overall Survival ◽

Head And Neck ◽

Muscle Mass ◽

Predictive Value ◽

Prognostic Value ◽

Skeletal Muscle Mass ◽

Cervical Vertebra ◽

Kaplan Meier ◽

Dose Limiting Toxicity

Abstract Purpose This study aims to investigate the predictive value of low skeletal muscle mass (SMM) for cetuximab dose-limiting toxicity (DLT) and its prognostic value in head and neck squamous cell carcinoma (HNSCC) patients treated with concomitant cetuximab and radiotherapy. Methods Patients diagnosed with HNSCC and treated with primary or adjuvant concomitant cetuximab and radiotherapy were included. Clinical and demographic variables were retrospectively retrieved and SMM was measured at the level of the third cervical vertebra using pre-treatment diagnostic computed tomography or magnetic resonance imaging. An optimal cut-off value for low SMM was determined based on the lowest log-likelihood associated with cetuximab DLT. A multivariate linear regression model was used to determine predictive factors for cetuximab DLT. The prognostic value of low SMM for disease-free and overall survival was analyzed using Kaplan–Meier curves. Results The optimal cut-off value for low SMM as a predictor of cetuximab DLT was an LSMI ≤ 45.2 cm2/m2. Of the 91 included patients, 74.7% had low SMM and 30.8% experienced cetuximab DLT. At multivariate analysis, low SMM had no predictive value for DLT (OR 0.83; 95% CI 0.27–2.56; p = 0.74). The Kaplan–Meier curve demonstrated that patients with low SMM had significantly lower overall survival (Log Rank χ2 = 5.87; p = 0.02). Conclusion Low SMM is highly prevalent in HNSCC patients treated with concomitant cetuximab and radiotherapy. Low SMM has no predictive value for cetuximab DLT in HNSCC patients. Low SMM is probably not a prognostic factor for overall survival in highly selected HNSCC patients treated with concomitant cetuximab and radiotherapy and unfit for platin-based chemotherapy.

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