Imaging-based evaluation of cervical muscle mass and 6-month survival in males with hypopharyngeal carcinoma.

IF 2.7 3区 医学 Q3 ONCOLOGY Acta Oncologica Pub Date : 2024-12-17 DOI:10.2340/1651-226X.2024.40481
Jouni Laurén, Harri Keski-Säntti, Antti Mäkitie, Otso Arponen
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Abstract

Background: A significant proportion of newly diagnosed patients with hypopharyngeal carcinoma (HC) are at risk of early death and may not benefit from cancer treatments. Our objective was to assess whether an image-based evaluation of muscle mass could identify patients at risk of impaired survival.

Materials and methods: This retrospective study consisted of male patients diagnosed with HC treated at Helsinki University Hospital between 2005 and 2014 (N = 66). Cross-sectional areas of skeletal muscles at the level of the third cervical vertebra (C3) and at the level of the thoracic aortic apex were analyzed using magnetic resonance images and/or computed tomography images. Survival-based cutoff values for low muscle index values were determined using the receiver operating characteristics curves. Kaplan-Meier analyses and Cox proportional hazard models were used to evaluate the associations between the muscle indexes and survival rates.

Results: Several muscle indexes were associated with 6-month and 5-year survival. The 6-month survival rate of males with a low sternocleidomastoid muscle index (cutoff 1.73 cm2/m2) was 66%, as opposed to the 97% survival rate for those with an above-the-cutoff muscle index (hazard ratio 13.0 [95% CI 1.5, 116.6]). In a multivariate Cox model adjusted for age, sex, tumor stage, and grade, lower sternocleidomastoid muscle index was significantly associated with decreased 6-month survival.

Interpretation: C3-level muscle indexes, particularly the sternocleidomastoid muscle index, are a promising marker in the identification of patients at risk of early mortality and could add confidence in decision-making when choosing between active and palliative care.

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下咽癌男性患者宫颈肌肉质量和 6 个月存活率的影像评估。
背景:很大一部分新诊断的下咽癌(HC)患者有早期死亡的风险,并且可能无法从癌症治疗中获益。我们的目的是评估基于图像的肌肉质量评估是否可以识别存在生存受损风险的患者。材料与方法:本回顾性研究纳入2005 - 2014年在赫尔辛基大学医院就诊的男性HC患者(N = 66)。使用磁共振成像和/或计算机断层成像分析第三颈椎(C3)水平和胸主动脉尖水平骨骼肌的横截面积。使用受试者工作特征曲线确定低肌肉指数值的生存截断值。Kaplan-Meier分析和Cox比例风险模型用于评估肌肉指数与生存率之间的关系。结果:一些肌肉指标与6个月和5年生存率相关。胸锁乳突肌指数低(临界值1.73 cm2/m2)的男性6个月生存率为66%,而肌肉指数高于临界值的男性6个月生存率为97%(风险比13.0 [95% CI 1.5, 116.6])。在调整了年龄、性别、肿瘤分期和分级的多变量Cox模型中,胸锁乳突肌指数较低与6个月生存率降低显著相关。结论:c3水平的肌肉指数,尤其是胸锁乳突肌指数,是鉴别早期死亡风险患者的一个有希望的指标,可以在选择积极治疗和姑息治疗时增加决策的信心。
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来源期刊
Acta Oncologica
Acta Oncologica 医学-肿瘤学
CiteScore
4.30
自引率
3.20%
发文量
301
审稿时长
3 months
期刊介绍: Acta Oncologica is a journal for the clinical oncologist and accepts articles within all fields of clinical cancer research. Articles on tumour pathology, experimental oncology, radiobiology, cancer epidemiology and medical radio physics are also welcome, especially if they have a clinical aim or interest. Scientific articles on cancer nursing and psychological or social aspects of cancer are also welcomed. Extensive material may be published as Supplements, for which special conditions apply.
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