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000182795 041__ $$aEnglish
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000182795 1001_ $$0P:(DE-HGF)0$$aHaehl, Erik$$b0
000182795 245__ $$aSarcopenia as a Prognostic Marker in Elderly Head and Neck Squamous Cell Carcinoma Patients Undergoing (Chemo-)Radiation.
000182795 260__ $$aBasel$$bMDPI$$c2022
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000182795 520__ $$aSarcopenia is associated with reduced survival and increased toxicity in malignant diseases. The prevalence of sarcopenia increases with age and is an important cause of functional decline. We analyzed sarcopenia and sarcopenia dynamics in elderly head-and-neck squamous cell carcinoma (HNSCC) patients undergoing (chemo)radiation. Skeletal muscle mass of 280 elderly HNSCC-patients (>65 yrs) receiving curative (chemo)radiation was manually outlined and quantified on CT scans at the level of the C3 (C3MA). Cross-sectional muscle area at L3 (L3MA) was calculated and normalized to height (L3MI). Frequency distributions of clinical parameters as well as overall survival (OS), progression-free survival (PFS) and locoregional control (LRC) were calculated regarding sarcopenia. Calculated L3MA correlated with pretherapeutic hemoglobin-levels (ρ = 0.280) bodyweight (ρ = 0.702) and inversely with patient-age (ρ = -0.290). Sarcopenic patients featured larger tumors (T3/4 69.0% vs. 52.8%, p < 0.001), a higher burden of comorbidity (age-adjusted Charlson Comorbidity Index 4.8 vs. 4.2, p = 0.015) and more severe chronic toxicities (CTCAE grade 3/4 24.0% vs. 11.8%, p = 0.022). OS was significantly deteriorated in sarcopenic patients with a median of 23 vs. 91 months (logrank p = 0.002) (HR 1.79, CI 1.22-2.60, p = 0.003) and sarcopenia remained an independent prognostic factor for reduced OS in the multivariate analysis (HR 1.64, CI 1.07-2.52, p = 0.023). After therapy, 33% of previously non-sarcopenic patients developed sarcopenia, while 97% of pre-treatment sarcopenic remained sarcopenic. Median bodyweight decreased by 6.8%, whereas median calculated L3MA decreased by 2.4%. In contrast to pretherapeutic, post-therapeutic sarcopenia is no prognosticator for reduced OS. Pretherapeutic sarcopenia is a significant prognostic factor in elderly HNSCC patients undergoing (chemo-)radiation and should be considered in pretherapeutic decision-making. Its role as a predictive marker for tailored supportive interventions merits further prospective evaluation.
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000182795 650_7 $$2Other$$aHNSCC
000182795 650_7 $$2Other$$aelderly
000182795 650_7 $$2Other$$ahead-and-neck cancer
000182795 650_7 $$2Other$$ahead-and-neck squamous cell carcinoma
000182795 650_7 $$2Other$$aradiotherapy
000182795 650_7 $$2Other$$asarcopenia
000182795 7001_ $$aAlvino, Luisa$$b1
000182795 7001_ $$0P:(DE-He78)80e100a16534f5fc67f7436ee67a47f9$$aRühle, Alexander$$b2
000182795 7001_ $$0P:(DE-HGF)0$$aZou, Jiadai$$b3
000182795 7001_ $$0P:(DE-HGF)0$$aFabian, Alexander$$b4
000182795 7001_ $$0P:(DE-HGF)0$$aGrosu, Anca-Ligia$$b5
000182795 7001_ $$0P:(DE-He78)8d52e7ff1ccaac7dbf0232fdcb0168bd$$aNicolay, Nils H$$b6$$eLast author
000182795 773__ $$0PERI:(DE-600)2527080-1$$a10.3390/cancers14225536$$gVol. 14, no. 22, p. 5536 -$$n22$$p5536$$tCancers$$v14$$x2072-6694$$y2022
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