Skip to main content

Advertisement

SpringerLink
Log in

Older adults, appendicular anthropometric measurements, and poor functional performance are predictors of sarcopenia in individuals with head and neck squamous cell carcinoma

  • Research
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Objective

To identify predictors of sarcopenia (demographical, anthropometric measurements, tumor-related clinical characteristics, performance status, and serum C-reactive protein (CRP) and albumin levels in individuals with head and neck squamous cell carcinoma (HNSCC).

Material and methods

This cross-sectional study selected diagnosed with HNSCC (n = 125). Sarcopenia was defined as low muscle strength and low physical performance. Association between sarcopenia and anthropometric assessments (weight, height, body mass index, triceps skinfold, mid-upper arm circumference [MUAC], mid-upper arm muscle circumference, mid-upper arm fat area [UFA], mid-upper arm bone free muscle area, calf circumference, and appendicular skeletal muscle mass and index), tumor clinical characteristics (anatomical site, tumor size, and cervical metastasis), performance status scale (Eastern Cooperative Oncology Group Performance Status [ECOG-PS]), and CRP and albumin levels was analyzed using binary logistic regression models.

Results

The diagnosis of sarcopenia was identified in 28 (22.4%) individuals with HNSCC. Being an older adult increases the odds of association with sarcopenia in individuals with HNSCC (odds ratio [OR] = 1.05). Increments in MUAC measurement reduce the odds of association with sarcopenia (OR = 0.69), while the increase in the UFA measurement increases the odds of association with sarcopenia (OR = 1.33). Poor ECOG-PS scores increase the odds of association with sarcopenia in individuals with HNSCC (OR = 5.54).

Conclusion

Early identification of easy-to-perform, cost-effective predictors of sarcopenia tends to favor the implementation of personalized therapeutic and supportive interventions in individuals with HNSCC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

The datasets analyzed during the current study are available from the corresponding author (de Paula, AMB) upon reasonable request.

References

  1. Johnson DE, Burtness B, Leemans CR, Lui VWY, Bauman JE et al (2020) Head and neck squamous cell carcinoma. Nat Rev Dis Primers 6:92. https://doi.org/10.1038/s41572-020-00224-3

    Article  PubMed  PubMed Central  Google Scholar 

  2. Zhang SZ, Xie L,Shang ZJ (2022) Burden of Oral Cancer on the 10 Most Populous Countries from 1990 to 2019: estimates from the Global Burden of Disease Study 2019. Int J Environ Res Public Health 19. https://doi.org/10.3390/ijerph19020875

  3. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O et al (2019) Writing GROUP FOR THE EUROPEAN WORKING GROUP ON SARCOPENIA in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. J Age Ageing 48:16–31

    Article  Google Scholar 

  4. Xia L, Zhao R, Wan Q, Wu Y, Zhou Y et al (2020) Sarcopenia and adverse health-related outcomes: an umbrella review of meta-analyses of observational studies. Cancer Med 9:7964–7978. https://doi.org/10.1002/cam4.3428

    Article  PubMed  PubMed Central  Google Scholar 

  5. Yuan S, Larsson SC (2023) Epidemiology of sarcopenia: prevalence, risk factors, and consequences. Metabolism 144:155533. https://doi.org/10.1016/j.metabol.2023.155533

    Article  PubMed  CAS  Google Scholar 

  6. Bano G, Trevisan C, Carraro S, Solmi M, Luchini C et al (2017) Inflammation and sarcopenia: a systematic review and meta-analysis. Maturitas 96:10–15

    Article  PubMed  Google Scholar 

  7. Webster JM, Kempen LJ, Hardy RS, Langen RC (2020) Inflammation and skeletal muscle wasting during cachexia. Front Physiol 11:597675

    Article  PubMed  PubMed Central  Google Scholar 

  8. Bhasin S, Travison TG, Manini TM, Patel S, Pencina KM et al (2020) Sarcopenia definition: the position statements of the sarcopenia definition and outcomes consortium. J Am Geriatr Soc 68:1410–1418. https://doi.org/10.1111/jgs.16372

    Article  PubMed  Google Scholar 

  9. Bohannon RW (2015) Muscle strength: clinical and prognostic value of handgrip dynamometry. Curr Opin Clin Nutr Metab Care 18:465–470. https://doi.org/10.1097/MCO.0000000000000202

    Article  PubMed  Google Scholar 

  10. Surov A, Wienke A (2022) Prevalence of sarcopenia in patients with solid tumors: A meta-analysis based on 81,814 patients. JPEN J Parenter Enteral Nutr 46:1761–1768. https://doi.org/10.1002/jpen.2415

    Article  PubMed  CAS  Google Scholar 

  11. Chargi N, Bril S, Emmelot-Vonk M, De Bree R (2019) Sarcopenia is a prognostic factor for overall survival in elderly patients with head-and-neck cancer. J Eur Arch Oto-Rhino-Laryngol 276:1475–1486

    Article  CAS  Google Scholar 

  12. Kirk B, Zanker J, Bani Hassan E, Bird S, Brennan-Olsen S et al (2021) Sarcopenia Definitions And Outcomes Consortium (SDOC) Criteria are strongly associated with malnutrition, depression, falls, and fractures in high-risk older persons. J Am Med Dir Assoc 22:741–745. https://doi.org/10.1016/j.jamda.2020.06.050

    Article  PubMed  Google Scholar 

  13. Silva PB, Ramos GHA, Petterle RR, Borba VZC (2021) Sarcopenia as an early complication of patients with Head and neck cancer with dysphagia. Eur J Cancer Care 30:e13343

    Article  Google Scholar 

  14. Meerkerk CD, Chargi N, de Jong PA, van den Bos F, de Bree R (2021) Sarcopenia measured with handgrip strength and skeletal muscle mass to assess frailty in older patients with head and neck cancer. J Geriatr Oncol 12:434–440

    Article  PubMed  CAS  Google Scholar 

  15. Takenaka Y, Takemoto N, Oya R, Inohara H (2021) Prognostic impact of sarcopenia in patients with head and neck cancer treated with surgery or radiation: a meta-analysis. PLoS ONE 16:e0259288

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  16. Vandenbroucke JP, von Elm E, Altman DG, Gotzsche PC, Mulrow CD et al (2007) Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Epidemiology 18:805–835. https://doi.org/10.1097/EDE.0b013e3181577511

    Article  PubMed  Google Scholar 

  17. Cawthon PM, Manini T, Patel SM, Newman A, Travison T et al (2020) Putative cut-points in sarcopenia components and incident adverse health outcomes: an SDOC analysis. J Am Geriatr Soc 68:1429–1437. https://doi.org/10.1111/jgs.16517

    Article  PubMed  PubMed Central  Google Scholar 

  18. Silva VSD, Vieira MFS (2020) International Society for the Advancement of Kinanthropometry (ISAK) Global: international accreditation scheme of the competent anthropometrist. Revista Brasileira de Cineantropometria & Desempenho Humano 22. https://doi.org/10.1590/1980-0037.2020v22e70517

  19. Barao K, Forones NM (2012) Body mass index: different nutritional status according to WHO, OPAS and Lipschitz classifications in gastrointestinal cancer patients. Arq Gastroenterol 49:169–171. https://doi.org/10.1590/s0004-28032012000200013

    Article  PubMed  Google Scholar 

  20. Frisancho AR (1990) Anthropometric standards for the assessment of growth and nutritional status, 1st edn. University of Michigan Press, Ann Arbor, MI, USA. https://doi.org/10.3998/mpub.12198

  21. Visvanathan R, Yu S, Field J, Chapman I, Adams R et al (2012) Appendicular skeletal muscle mass: development and validation of anthropometric prediction equations. J Frailty Aging 1:147–151. https://doi.org/10.14283/jfa.2012.23

    Article  PubMed  CAS  Google Scholar 

  22. Pagotto V, Santos KFD, Malaquias SG, Bachion MM, Silveira EA (2018) Calf circumference: clinical validation for evaluation of muscle mass in the elderly. Rev Bras Enferm 71:322–328. https://doi.org/10.1590/0034-7167-2017-0121

    Article  PubMed  Google Scholar 

  23. West HJ, Jin JO (2015) JAMA oncology patient page. Performance status in patients with cancer. JAMA Oncol 1:998. https://doi.org/10.1001/jamaoncol.2015.3113

    Article  PubMed  Google Scholar 

  24. Gugić J, Strojan P (2013) Squamous cell carcinoma of the Head and neck in the elderly. Rep Pract Oncol Radiother 18:16–25

    Article  Google Scholar 

  25. Ali S, Garcia JM (2014) Sarcopenia, cachexia and aging: diagnosis, mechanisms and therapeutic options - a mini-review. Gerontology 60:294–305. https://doi.org/10.1159/000356760

    Article  PubMed  CAS  Google Scholar 

  26. Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E et al (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12:489–495. https://doi.org/10.1016/S1470-2045(10)70218-7

    Article  PubMed  Google Scholar 

  27. Dunne RF, Loh KP, Williams GR, Jatoi A, Mustian KM et al (2019) Cachexia and sarcopenia in older adults with cancer: a comprehensive review. Cancers 11. https://doi.org/10.3390/cancers11121861

  28. Orell-Kotikangas H, Österlund P, Mäkitie O, Saarilahti K, Ravasco P et al (2017) Cachexia at diagnosis is associated with poor survival in head and neck cancer patients. Acta Otolaryngol 137:778–785

    Article  PubMed  CAS  Google Scholar 

  29. Frisancho AR (1981) New norms of upper limb fat and muscle areas for assessment of nutritional status. Am J Clin Nutr 34:2540–2545. https://doi.org/10.1093/ajcn/34.11.2540

    Article  PubMed  CAS  Google Scholar 

  30. Zhuang CL, Zhang FM, Xu HX, Weng M, Yao Y, Zhou FX, Li ZN, Guo ZQ, Li T, Li W, Shi HP, Investigation on Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) Group (2022) Reference values of low body mass index, mid-upper arm circumference, and calf circumference in cancer patients: a nationwide multicenter observational study. Nutrition 99–100:111688. https://doi.org/10.1016/j.nut.2022.111688

  31. Gort-van Dijk D, Weerink LBM, Milovanovic M, Haveman JW, Hemmer PHJ et al (2021) Bioelectrical Impedance analysis and mid-upper arm muscle circumference can be used to detect low muscle mass in clinical practice. Nutrients 13. https://doi.org/10.3390/nu13072350

  32. Murphy RA, Wilke MS, Perrine M, Pawlowicz M, Mourtzakis M et al (2010) Loss of adipose tissue and plasma phospholipids: relationship to survival in advanced cancer patients. Clin Nutr 29:482–487. https://doi.org/10.1016/j.clnu.2009.11.006

    Article  PubMed  CAS  Google Scholar 

  33. Arends J, Baracos V, Bertz H, Bozzetti F, Calder PC et al (2017) ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr 36:1187–1196. https://doi.org/10.1016/j.clnu.2017.06.017

    Article  PubMed  CAS  Google Scholar 

  34. Ferrão B, Neves PM, Santos T, Capelas ML, Mäkitie A et al (2020) Body composition changes in patients with Head and neck cancer under active treatment: a scoping review. Support Care Cancer 28:4613–4625

    Article  PubMed  Google Scholar 

  35. Granström B, Holmlund T, Laurell G, Fransson P, Tiblom Ehrsson Y (2022) Addressing symptoms that affect patients’ eating according to the head and neck patient symptom checklist©. Support Care Cancer 30(7):6163–6173. https://doi.org/10.1007/s00520-022-07038-x

    Article  PubMed  PubMed Central  Google Scholar 

  36. Jager-Wittenaar H, Dijkstra PU, Vissink A, van der Laan BF, van Oort RP et al (2007) Critical weight loss in head and neck cancer–prevalence and risk factors at diagnosis: an explorative study. Support Care Cancer 15:1045–1050. https://doi.org/10.1007/s00520-006-0212-9

    Article  PubMed  Google Scholar 

  37. Lidoriki I, Schizas D (2018) Are body mass index and performance status enough to assess the nutritional and functional status of elderly patients undergoing gastric cancer surgery? Surg Today 48:1100–1101

    Article  PubMed  Google Scholar 

  38. Oflazoglu U, Alacacioglu A, Varol U, Kucukzeybek Y, Salman T et al (2020) Prevalence and related factors of sarcopenia in newly diagnosed cancer patients. Support Care Cancer 28:837–843

    Article  PubMed  Google Scholar 

  39. Beaudart C, Rizzoli R, Bruyere O, Reginster JY, Biver E (2014) Sarcopenia: burden and challenges for public health. Arch Public Health 72:45. https://doi.org/10.1186/2049-3258-72-45

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors acknowledge Hospital Universitário Clemente de Farias (HUCF) of the Universidade Estadual de Montes Claros (UNIMONTES) and Fundação Hospitalar Dilson Godinho.

Funding

We want to thank the Foundation for Research Support of the Minas Gerais State (FAPEMIG, PPM-00029–17), National Council for Scientific and Technological Development (CNPq, Processes Number: 437311/2016–3 and 430759/2016–9), and the Coordination of Improvement of Higher Education Personnel (CAPES) for the support to carry out this study. de Paula AMBP is a member of the Minas Gerais Research Network Translational Studies in Immunobiologicals and Biopharmaceuticals in Cancer (FAPEMIG, RED-00031–21).

Author information

Authors and Affiliations

  1. Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil

    Luciana Mara Barbosa Pereira, Hérika Maria Silveira Ruas, Walter de Freitas Filho, Wislene Sarajane Moreira Alves, Gabrielle Oliveira Dias, Cristina Paixão Durães, Renato Sobral Monteiro-Junior, Sérgio Henrique Sousa Santos, Lucyana Conceição Farias, André Luiz Sena Guimarães, Desirée Sant´Ana Haikal, Cláudio Marcelo Cardoso & Alfredo Mauricio Batista de Paula

  2. Head and Neck Surgery and Oncology Center, Fundação de Saúde Hospital Dilson de Quadros Godinho, Montes Claros, Minas Gerais, 39400-292, Brazil

    Wislene Sarajane Moreira Alves, Cristina Paixão Durães & Cláudio Marcelo Cardoso

  3. Department of Physical Education, Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, Minas Gerais, 39401-001, Brazil

    Renato Sobral Monteiro-Junior

  4. Departament of Food Engineering, Institute of Agricultural Sciences, Universidade Federal de Minas Gerais (UFMG), Montes Claros, Minas Gerais, 39404-547, Brazil

    Sérgio Henrique Sousa Santos

  5. Department of Dentistry, Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, Minas Gerais, 39401-001, Brazil

    Lucyana Conceição Farias, André Luiz Sena Guimarães, Desirée Sant´Ana Haikal & Alfredo Mauricio Batista de Paula

Authors
  1. Luciana Mara Barbosa Pereira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hérika Maria Silveira Ruas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Walter de Freitas Filho
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wislene Sarajane Moreira Alves
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gabrielle Oliveira Dias
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Cristina Paixão Durães
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Renato Sobral Monteiro-Junior
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Sérgio Henrique Sousa Santos
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Lucyana Conceição Farias
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. André Luiz Sena Guimarães
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Desirée Sant´Ana Haikal
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Cláudio Marcelo Cardoso
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Alfredo Mauricio Batista de Paula
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

This study was conceived and designed by AMBdP and LMBP, who drafted the manuscript. HMSR, HMS, WdFF, WSMA, CPD, GOD, LMBP and RSMJ performed the activities of anthropometric measurements, handgrip strength, and physical performance tests. LMBP, WSMA, WdFF, and GOD collected peripheral blood samples. LCF, SHSS, and LMBP performed the expression tests of serum biomarkers investigated in the study. DSH and LMBP assisted in the study’s statistical analysis. ALSG, DSH, and SHSS critically revised the manuscript. CMC established TNM clinical staging and performed physical performance assessments of participants. All authors involved in this present study approved the final version of the manuscript.

Corresponding author

Correspondence to Alfredo Mauricio Batista de Paula.

Ethics declarations

Ethical approval and consent to participate

All procedures performed by participants of this study followed the ethical standards of the institutional and national research committee (CEP/Unimontes; protocol number: 3.202.795; CAAE 09006719.1.0000.5146) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All participants signed a consent form that informed them about the study’s design of this study before they were selected for participation.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pereira, L.M.B., Ruas, H.M.S., de Freitas Filho, W. et al. Older adults, appendicular anthropometric measurements, and poor functional performance are predictors of sarcopenia in individuals with head and neck squamous cell carcinoma. Support Care Cancer 32, 82 (2024). https://doi.org/10.1007/s00520-023-08254-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00520-023-08254-9

Keywords

Search

Navigation