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CC BY 4.0 · Indian J Med Paediatr Oncol 2023; 44(04): 391-397
DOI: 10.1055/s-0043-1768690
Review Article

Impact of Sarcopenia on Head and Neck Cancer Treatment: A Review of Literature

Balateja Kantamani
1   Head and Neck Surgery Department, Tata Memorial Hospital, Affiliated to the Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Manasi Bavaskar
2   Department of Head and Neck Surgery, Homi Bhabha National Institute, ACTREC, Tata Memorial Centre, Navi Mumbai, Maharashtra, India
,
Rathan Shetty
3   ACTREC, Tata Memorial Centre, Navi Mumbai, Affiliated to the Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Hitesh R. Singhavi 
4   Department of Surgical Oncology, Fortis Hospital, Mulund, Mumbai, Maharashtra, India
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Abstract

The overall outcome of head and neck cancer (HNC) patients undergoing any treatment modality may significantly depend upon their general nutritional condition. Poor nutritional status leading to sarcopenia may be a negative prognostic factor in determining the outcome of HNC patients. PubMed database was searched to identify studies published between 2015 and 2022. All studies reporting the index for sarcopenia as well as its effect on HNC were included. This narrative review was conducted to specifically evaluate the impact of sarcopenia on HNC patients undergoing surgery/ free flap reconstruction/ adjuvant treatment. In oncology, computed tomography assessment of skeletal mass at C3 and L3 is the most suitable index to detect sarcopenia. From the articles yielded, the prevalence rate of sarcopenia ranges from 6 to 70% worldwide. Indian population presents with a significantly higher rate of 31.5% sarcopenia HNC patients. Sarcopenic patients have an increased propensity for surgical site infections, as high as 24.6% owing to the reduced skeletal muscle mass. These patients are also prone to have frequent breaks during radiation treatment of more than 1 week and increased chemotherapy-related toxicities. Further, sarcopenic individuals tend to have higher Ryle's tube dependency of more than 90 days. Sarcopenic patients undergoing surgery have a poor overall survival (OS) and disease-free survival (DFS). In terms of hazards ratio, sarcopenic patients have 1.96 times poor OS and 2.00 times poor DFS when compared to normal individuals who undergo HNC surgery. Sarcopenia is an indispensable part of cancer ailment and it is an independent factor negatively influencing DFS and OS. Thus, nutritional strategy needs to be developed to mitigate sarcopenic effects, especially in the Indian population in preoperative setting.

Keywords

sarcopenia - head and neck cancer - chemotherapy - radiation - overall survival - sarcopenic index


Publication History

Article published online:
08 May 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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