Abstract 920P
Background
In cancer, sarcopenia is an important predictor of adverse outcome and treatment-related toxicity. SMI is an established surrogate of sarcopenia for advanced head and neck squamous cell carcinoma (aHNSCC) patients (pts). However, ideal cut-off values for prognostication and biochemical predictors of SMI are under reported for pts approaching a first-line chemotherapy.
Methods
SMI was calculated as per standard at the baseline CT scan in consecutive aHNSCC pts candidate for a first-line chemotherapy. Hazard Ratio Smoothed Curve (HRSC) analysis was used to identify ideal SMI cut-off values. Multivariate logistic regression (MLR) with LASSO analysis was performed to identify biochemical predictors of poor SMI. Survival was reported in months (mo).
Results
HRSC revealed a three-tier prognostic effect of SMI in 83 included pts: SMI <31 (poor risk, mOS 9.2 mo), SMI 31-44 (intermediate risk, mOS 33.1 mo), SMI >44 (good risk, mOS not reached after a mFollow-Up of 38.6 mo), HR of 11.4 (p=0.0003) and 4.2 (p=0.02) for poor and intermediate risk, respectively, taking as a reference SMI >44. Twenty biochemical variables were analyzed with MLR-LASSO and Hb <12 g/dL, Ly <1.5/mL and Cre <0.8 mg/dL were all found to be independent predictors of poor SMI: Odds Ratio (OR) 13.7 (p=0.004), 12.9 (p=0.009) and 14.9 (p=0.03), respectively. These three variables were used to build a model with a discriminatory power of 92% (C-statistics). The prevalence of poor SMI was for all three predictors unfavorable, mixed unfavorable/favorable and all three favorable of 66% (OR 29860.7), 13% (OR 2132.8) and 0% (reference), respectively, p <0.0001.
Conclusions
SMI was confirmed to be a powerful prognostic factor in HNSCC patients with three distinct risk categories. We built a model based on 3 routinely available biochemical parameters that can identify those sarcopenic patients with a poorer outcome.
Clinical trial identification
Editorial acknowledgement
This research work has been conducted under the Programme on Experimental System and Medicine (XXXV cycle) at the University of Rome Tor Vergata.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.