Evaluating the prognosis of oral squamous cell carcinoma patients via L3 skeletal muscle index

Oral Dis. 2023 Apr;29(3):923-932. doi: 10.1111/odi.14074. Epub 2021 Nov 24.

Abstract

Objectives: This study aimed to construct a formula to predict L3 skeletal muscle cross-sectional area (CSA) from C3 CSA and to select the cutoff values to evaluate the nutritional status in OSCC.

Materials and methods: A total of 220 OSCC patients in Nanfang Hospital were divided into two groups: the training set (n = 100) and the validation set (n = 120). Patients in the training set were performed the preoperative whole-body positron emission tomography-computed tomography (PET/CT) scans, and patients in the validation set received preoperative head-and-neck computed tomography (CT) scans. C3 CSA and L3 CSA were delineated. The predictive formula was established, and the gender-specific thresholds of malnutrition were obtained by X-tile software in training set. Finally, the formula and cutoff values were validated.

Results: The predictive formula was successfully established. The gender-specific cutoff values for L3 SMI were 55.0 cm2 /m2 for men and 36.6 cm2 /m2 for women. There were no differences between the overall survival (OS) of patients diagnosed with malnutrition and that of patients who are not malnutrition.

Conclusions: Our studies reveal that the L3 CSA could be calculated by C3 CSA conveniently with our formula in OSCC, which allowed us to assess malnutrition with head-and-neck CT image. However, there is no direct connection found between malnutrition and OS in OSCC. Hence, further studies with a larger sample size may be required.

Keywords: computed tomography (CT); malnutrition; nutrition; oncology; oral squamous cell carcinoma (OSCC); sarcopenia.

MeSH terms

  • Carcinoma, Squamous Cell* / complications
  • Carcinoma, Squamous Cell* / diagnostic imaging
  • Carcinoma, Squamous Cell* / pathology
  • Female
  • Head and Neck Neoplasms* / complications
  • Head and Neck Neoplasms* / diagnostic imaging
  • Head and Neck Neoplasms* / pathology
  • Humans
  • Male
  • Malnutrition* / etiology
  • Mouth Neoplasms* / complications
  • Mouth Neoplasms* / diagnostic imaging
  • Mouth Neoplasms* / pathology
  • Muscle, Skeletal / diagnostic imaging
  • Muscle, Skeletal / pathology
  • Positron Emission Tomography Computed Tomography
  • Prognosis
  • Retrospective Studies
  • Sarcopenia* / diagnosis
  • Sarcopenia* / pathology
  • Squamous Cell Carcinoma of Head and Neck / pathology