Sarcopenia Trajectories Predict Survival in Operable Head and Neck Cancer.

Abstract

Sarcopenia is associated with increased treatment toxicity and survival in head and neck squamous cell cancer (HNSCC). This study evaluates sarcopenia trajectories and their association with overall survival (OS) and disease-free survival (DFS) in operable HNSCC. Pre- and post-treatment body composition metrics of patients with stage II-IV HPV-negative HNSCC undergoing surgery were performed. Sarcopenia trajectories were categorized as remains sarcopenic, remains non-sarcopenic, recovers from sarcopenia, or progresses to sarcopenia using multiple Cox regression. Of 332 patients, 108 were sarcopenic at baseline, and 106 remained sarcopenic post-treatment. Patients who remained sarcopenic or progressed to sarcopenia demonstrated significantly worse OS (HR: 2.08, 95% CI: 1.27-3.41 and HR: 3.05, 95% CI: 1.40-6.62) and DFS (HR: 1.79, 95% CI: 1.17-2.72 and HR: 2.12, 95% CI: 1.03-4.36), compared to those who remained non-sarcopenic while adjusting for confounding factors. Sarcopenia trajectories represent dynamic biomarkers that predict oncologic outcome in patients with operable HNSCC.