CT-assessed sarcopenia and prognostic nutritional index are associated with poor prognosis in oral squamous cell carcinoma.

Abstract

Abstract Purpose Recently, it has been reported that sarcopenia and nutritional evaluation are associated with the prognosis of patients with cancer; however, there are only a few detailed reports on oral cancer. This single center retrospective study aimed to analyze the relationship between computed tomography (CT)-defined sarcopenia, immunocompetence, nutritional status, and the prognosis of patients with oral squamous cell carcinoma (OSCC). Methods We included 146 patients who underwent initial radical surgery as first-line treatment for OSCC. Skeletal muscle in the third cervical vertebra (C3) was measured using preoperative cervical CT, and the skeletal muscle index (SMI) was calculated. Sarcopenia and nutritional status were investigated using blood tests. The correlation between each parameter and prognosis was analyzed. Survival rates were calculated using the Kaplan–Meier method. Log-rank and chi-square tests were used to compare survival rates between groups, and multivariate analysis was performed using the Cox proportional hazards model. Results Patients included 67 men and 79 women, from 20 to 94 years. The number of patients with sarcopenia defined using preoperative CT (CT-SP) was 76 (52%). In univariate analysis, CT-SP, prognostic nutritional index (PNI), and lymphocyte-monocyte ratio (LMR) were associated with poor prognosis, with statistically significant differences in disease-specific survival (DSS) and overall survival. In multivariate analysis, only CT-SP was identified as an independent prognostic factor for DSS. A statistically significant correlation between CT-SP and PNI was found. Conclusion CT-SP is associated with a significant decrease in survival rate in patients with OSCC. Furthermore, CT-SP is correlated with PNI.