Effect of Pre-Existing Sarcopenia on Oncological Outcomes for Oral Cavity Squamous Cell Carcinoma Undergoing Curative Surgery: A Propensity Score-Matched, Nationwide, Population-Based Cohort Study.

Abstract

Simple SummaryAlthough sarcopenia during cancer diagnosis is an independent prognostic factor for poor overall survival in patients with various cancers, whether pre-existing sarcopenia is an independent risk factor for oral cavity squamous cell carcinoma (OCSCC) remains unclear. Therefore, we conducted a head-to-head propensity score matching (PSM) study to estimate the oncological outcomes of pre-existing sarcopenia in patients with OCSCC undergoing curative surgery. Both univariate and multivariate Cox regression analyses indicated that pre-existing sarcopenia was associated with poor survival than nonsarcopenia. Old age, male sex, advanced pT, advanced pN, differentiation grade II–III, margin-positive cancer, lymphovascular invasion, and CCI ≥ 1 were significant poor prognostic factors for survival in the patients with OCSCC undergoing curative surgery.Purpose: The effect of pre-existing sarcopenia on patients with oral cavity squamous cell carcinoma (OCSCC) remains unknown. Therefore, we designed a propensity score-matched population-based cohort study to compare the oncological outcomes of patients with OCSCC undergoing curative surgery with and without sarcopenia. Patients and Methods: We included patients with OCSCC undergoing curative surgery and categorized them into two groups according to the presence or absence of pre-existing sarcopenia. Patients in both the groups were matched at a ratio of 2:1. Results: The matching process yielded 16,294 patients (10,855 and 5439 without and with pre-existing sarcopenia, respectively). In multivariate Cox regression analyses, the adjusted hazard ratio (aHR, 95% confidence interval [CI]) of all-cause mortality for OCSCC with and without pre-existing sarcopenia was 1.15 (1.11–1.21, p < 0.0001). Furthermore, the aHRs (95% CIs) of locoregional recurrence and distant metastasis for OCSCC with and without pre-existing sarcopenia were 1.07 (1.03–1.18, p = 0.0020) and 1.07 (1.03–1.20, p = 0.0148), respectively. Conclusions: Pre-existing sarcopenia might be a significant poor prognostic factor for overall survival, locoregional recurrence, and distant metastasis for patients with OCSCC undergoing curative surgery. In susceptible patients at a risk of OCSCC, sarcopenia prevention measures should be encouraged, such as exercise and early nutrition intervention.