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ORL J Otorhinolaryngol Relat Spec. 2018;80(1):1-9. doi: 10.1159/000485515. Epub 2018 Jan 26.

The Impact of Skeletal Muscle Depletion on Head and Neck Squamous Cell Carcinoma.



Skeletal muscle depletion and sarcopenia have been reported as poor prognostic factors for several types of cancer. The aim of this study was to investigate the prognostic impact of skeletal muscle depletion and sarcopenia on the outcomes in head and neck cancer patients.


Patients with head and neck squamous cell carcinoma (HNSCC) treated from January 2013 to June 2014 were included in this study. The pretreatment cross-sectional area of skeletal muscle at the third lumbar vertebra (L3) was measured by computed tomography image analysis using the ImageJ software. L3 skeletal muscle index (SMI) and fat-free mass (FFM) were calculated.


Eighty-five patients with HNSCC were included. The cut-off value of sarcopenia was set at SMI <46.7 cm2/m2 (males) and 30.3 cm2/m2 (females). The cut-off value of FFM was set at 42.3 kg (males) and 30.6 kg (females). Patients with a low SMI (sarcopenia) and low FFM had a significantly poorer prognosis than others, especially those who received definitive radiotherapy. Sarcopenia and low FFM are independent factors for poor prognosis in patients with HNSCC.


The skeletal muscle area at L3 should be calculated when considering treatment options for head and neck cancer.


Fat-free mass; Head and neck cancer; ImageJ; Sarcopenia; Skeletal muscle index

[Indexed for MEDLINE]

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