Prognostic impact of low muscularity in metastatic and recurrent head and neck cancer: Insights from C3-based assessments

Abstract

Head and Neck Cancer (HNC) patients often experience a range of symptoms due to disease which can lead to low energy and protein intake. This scenario can impact body composition as the quality and quantity of muscularity and adiposity changes. This work aims to evaluate the impact of muscularity on the overall survival (OS) of patients with metastatic HNC. This is a retrospective and analytical study, with the population studied being patients diagnosed with metastatic or recurrent HNC, between January 2010 and December 2018, treated at the Clinical Oncology outpatient clinic of the Hospital de Clínicas of the Universidade Estadual de Campinas. To assess body composition, CT images were used at the level of the third cervical vertebra (C3), with the areas of muscle tissue and adipose tissue. The total population included in the sample was 101 patients diagnosed with metastatic or recurrent HNC. It has been shown that low muscularity is associated with the elderly population over 70 years old and with a lower BMI value, below 18.5. The population with low muscularity had a lower amount of total adipose tissue and total adipose tissue index, as well as a lower amount of skeletal muscle and skeletal muscle index in relation to normal muscularity, making it possible to conclude that low muscularity in patients with metastatic or recurrent HNC is an independent factor for mortality.

Keywords: Body composition; Computed tomography; Metastatic neoplasm; Muscle mass; Survival.