Abstract 367P
Background
Radiologically defined sarcopenia has been associated with adverse oncological outcomes, with CT imaging being an expedient tool for determining sarcopenia in cancer patients. The objective of this meta-analysis is to assess the association of sarcopenia defined on CT head and neck with survival in head and neck cancer patients.
Methods
Following a PROSPERO-registered protocol, three reviewers conducted a systematic review of the PubMed, Embase and Cochrane Library for observational studies that reported the presence of sarcopenia in association with mortality estimates. Two blinded reviewers extracted data and evaluated the quality of included studies using the Quality of Prognostic Studies tool and the Grading of Recommendations, Assessment, Development and Evaluations framework. A meta-analysis was conducted using maximally adjusted hazard ratios for mortality estimates and correlation coefficients. Heterogeneity was investigated using meta-regression and subgroup analyses.
Results
From 33 studies (9083 participants), sarcopenia was associated with poorer overall survival (HR, 2.09; 95% CI, 1.77 to 2.47; p = .01), disease-free survival (HR, 1.76; 95% CI, 1.38 to 2.24; p < .01) disease-specific survival (HR, 2.24; 95% CI, 1.82 to 3.67; p < .01), progression-free survival (HR, 2.24; 95% CI, 1.82 to 3.67; p < .01) and increased chemotherapy or radiotherapy toxicity (RR, 2.28; 95% CI, 1.31 to 3.95; p < .01). Overall survival was significantly poorer in studies with mean BMI <25 kg/m2 compared with studies with mean BMI ≥25 kg/m2. The observed association between sarcopenia and overall survival remained significant across different locations of cancer, treatment modality, tumor stages and geographical region, and did not differ between univariate and multivariate hazard ratios. Statistically significant correlations were observed between C3 and L3 cross-sectional area, skeletal muscle mass and skeletal muscle index.
Conclusions
Among patients with head and neck cancers, CT-defined sarcopenia was consistently associated with poorer survival and greater toxicity. Our findings are easily applicable in clinical practice, by measuring sarcopenia at the C3 vertebra on routine staging CT scans.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
National University of Singapore.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
26P - Subcutaneous trastuzumab versus intravenous trastuzumab for treatment of patients with HER2-positive breast cancer: A time, motion and cost-benefit assessment in a day care oncology unit in China
Presenter: Bei Sun
Session: Poster Display
Resources:
Abstract
27P - The biological characteristics of HER2-low in TNBC using mRNA profiling and molecular subtypes
Presenter: Asako Tsuruga
Session: Poster Display
Resources:
Abstract
28P - One-week ultra-hypofractionated partial breast RT in early breast cancer: 3DCRT vs IMRT
Presenter: Nurilla Zaynutdinov
Session: Poster Display
Resources:
Abstract
30P - Stereotactic body radiotherapy using cyberknife versus interstitial brachytherapy in accelerated partial breast irradiation on left-sided breast: A comparison of preliminary clinical result and dosimetric characteristics
Presenter: Ting-Na Wei
Session: Poster Display
Resources:
Abstract
31P - Prognostic implication of breast edema on preoperative breast MRI in breast cancer
Presenter: Ki-tae Hwang
Session: Poster Display
Resources:
Abstract
32P - Efficacy of olanzapine in the prophylaxis of delayed chemotherapy-induced nausea and vomiting in breast cancer patients receiving dose-dense AC with a steroid-sparing regimen: A single-center pilot study
Presenter: Manami Tada
Session: Poster Display
Resources:
Abstract
34P - Social support as the mediator of the association between unmet needs and happiness among women with early breast cancer
Presenter: Nithiya Sinarajoo
Session: Poster Display
Resources:
Abstract
35P - Prospective study assessing the efficacy and safety of a scalp cooling device for the prevention of alopecia in breast cancer patients undergoing (neo)adjuvant chemotherapy
Presenter: Winnie Yeo
Session: Poster Display
Resources:
Abstract
37P - To excise or not to excise: Preventive management of early breast cancer in atypical ductal hyperplasia patients
Presenter: Clarisse Hing
Session: Poster Display
Resources:
Abstract
38P - Exploring prognostic factors in patients achieving PCR after neoadjuvant therapy for triple-negative breast cancer: A retrospective study based on SEER data
Presenter: Lv Wenjie
Session: Poster Display
Resources:
Abstract