Impact of Preoperative Low Prognostic Nutritional Index and High Intramuscular Adipose Tissue Content on Outcomes of Patients with Oral Squamous Cell Carcinoma.

Takuya Yoshimura,Hirotaka Takayama,Masahiro Tezuka,Norifumi Nakamura,Yuka Hirano,Yasunori Nakamura,Kiyohide Ishihata,Yasushi Imamura,Takayuki Ishida,Hajime Suzuki,Shotaro Higashi,Etsuro Nozoe,Yasuhiro Nishi

doi:10.3390/cancers12113167

Abstract

Simple SummaryOral squamous cell carcinoma (OSCC) has the highest mortality rate among all head and neck cancers. To date, the impact of preoperative malnutrition and sarcopenia on survival in OSCC patients remains controversial. The aim of our study was to investigate the effects of preoperative nutritional status and abnormalities in body composition on the mortality of OSCC patients. The disease-specific survival (DSS) rate among patients with a high intramuscular adipose tissue content (IMAC) and a low psoas muscle mass index was significantly lower than that in controls. Multivariate analysis revealed that a low preoperative Prognostic Nutritional Index (PNI) and high IMAC were independent risk factors. We demonstrated that preoperative malnutrition and abnormal body composition, such as abnormal preoperative skeletal muscle quality, are associated with DSS in OSCC patients. Our study suggests that the evaluation of preoperative malnutrition and skeletal muscle quality would be useful for predicting mortality in patients with OSCC.The impact of preoperative malnutrition and sarcopenia on survival in oral squamous cell carcinoma (OSCC) patients remains controversial. We investigated the effects of the preoperative nutritional status and abnormalities in body composition on the mortality of OSCC patients. A retrospective study involving 103 patients with OSCC was conducted. Disease-specific survival (DSS) according to the preoperative psoas muscle mass index (PMI) and intramuscular adipose tissue content (IMAC) was evaluated. Univariate and multivariate analyses were performed to determine the predictive performance of the covariates with respect to DSS. The DSS rate in patients with high IMAC and low PMI was significantly lower than that in controls. Multivariate analysis revealed that a low preoperative Prognostic Nutritional Index (PNI) and high IMAC were independent risk factors. We demonstrated that preoperative malnutrition and abnormal body composition, such as preoperative skeletal muscle quality, are associated with DSS in OSCC patients. Our study suggests that the evaluation of preoperative malnutrition and skeletal muscle quality would be useful for predicting mortality in patients with OSCC.

Highlights

Oral squamous cell carcinoma (OSCC) has the highest mortality rate among all head and neck cancers (HNCs) [1], even though advances in treatment have improved survival rates.Recently, the global estimates have revealed 354,864 new cases and 177,384 deaths in 2018, which ranksoral squamous cell carcinoma (OSCC) sixth in terms of incidence rate among malignant tumors worldwide [1,2]
These results suggest a positive correlation between the preoperative comorbidity of sarcopenia and the mortality of OSCC patients
The present study revealed the potential effect of both malnutrition and sarcopenia on survival in OSCC

Summary

Introduction

OSCC sixth in terms of incidence rate among malignant tumors worldwide [1,2]. The incidence of OSCC has increased in many countries, especially in younger individuals, but whether young and old patients with OSCC have a different prognosis is controversial [2]. Recent studies have revealed no significant differences in tumor stage or grade in the comparisons of the characteristics of OSCC in young and old patients [3,4,5]. The discovery of factors that facilitate OSCC prognosis is one of the key challenges that we need to overcome. A previous report described that up to 46–49% of patients with HNC have a significantly higher risk of severe malnutrition and subsequent sarcopenia than patients with other malignancies [6]

Objectives

Methods

Discussion

Conclusion