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Effect of Pre-Existing Sarcopenia on Oncological Outcomes for Oral Cavity Squamous Cell Carcinoma Undergoing Curative Surgery: A Propensity Score-Matched, Nationwide, Population-Based Cohort Study

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Simple Summary Although sarcopenia during cancer diagnosis is an independent prognostic factor for poor overall survival in patients with various cancers, whether pre-existing sarcopenia is an independent risk factor for… Click to show full abstract

Simple Summary Although sarcopenia during cancer diagnosis is an independent prognostic factor for poor overall survival in patients with various cancers, whether pre-existing sarcopenia is an independent risk factor for oral cavity squamous cell carcinoma (OCSCC) remains unclear. Therefore, we conducted a head-to-head propensity score matching (PSM) study to estimate the oncological outcomes of pre-existing sarcopenia in patients with OCSCC undergoing curative surgery. Both univariate and multivariate Cox regression analyses indicated that pre-existing sarcopenia was associated with poor survival than nonsarcopenia. Old age, male sex, advanced pT, advanced pN, differentiation grade II–III, margin-positive cancer, lymphovascular invasion, and CCI ≥ 1 were significant poor prognostic factors for survival in the patients with OCSCC undergoing curative surgery. Abstract Purpose: The effect of pre-existing sarcopenia on patients with oral cavity squamous cell carcinoma (OCSCC) remains unknown. Therefore, we designed a propensity score-matched population-based cohort study to compare the oncological outcomes of patients with OCSCC undergoing curative surgery with and without sarcopenia. Patients and Methods: We included patients with OCSCC undergoing curative surgery and categorized them into two groups according to the presence or absence of pre-existing sarcopenia. Patients in both the groups were matched at a ratio of 2:1. Results: The matching process yielded 16,294 patients (10,855 and 5439 without and with pre-existing sarcopenia, respectively). In multivariate Cox regression analyses, the adjusted hazard ratio (aHR, 95% confidence interval [CI]) of all-cause mortality for OCSCC with and without pre-existing sarcopenia was 1.15 (1.11–1.21, p < 0.0001). Furthermore, the aHRs (95% CIs) of locoregional recurrence and distant metastasis for OCSCC with and without pre-existing sarcopenia were 1.07 (1.03–1.18, p = 0.0020) and 1.07 (1.03–1.20, p = 0.0148), respectively. Conclusions: Pre-existing sarcopenia might be a significant poor prognostic factor for overall survival, locoregional recurrence, and distant metastasis for patients with OCSCC undergoing curative surgery. In susceptible patients at a risk of OCSCC, sarcopenia prevention measures should be encouraged, such as exercise and early nutrition intervention.

Keywords: undergoing curative; existing sarcopenia; pre existing; curative surgery

Journal Title: Cancers
Year Published: 2022

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