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Cross-sectional analysis of myosteatosis and physical function in pretreatment head and neck cancer patients

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Abstract

Background

Head and neck cancer (HNC) and its treatment are associated with muscle weakness and considerable long-term comorbidity. The goal of this study was to determine whether skeletal muscle density (SMD) as quantified from pretreatment computed tomography (CT) scans will correlate with measures of function and strength prior to treatment in physical function in HNC patients.

Patients and methods

A cross-sectional analysis was conducted on 90 HNC patients. SMD (myosteatosis vs. normal) was calculated from pretreatment CT scans using SliceOmatic software. Pretreatment physical function was assessed via handgrip strength (HGS), the timed up and go test (TUG), and the short physical performance battery (SPPB). Demographic, cancer, and social characteristics were also collected as confounders. Linear regression models assessed the association between myosteatosis and measures of physical function.

Results

The 90 patients were predominately White, male, former smokers with an average BMI of 28.7 ± 5.7 kg/m2. Among men, adjusted models indicate, as compared to those with normal muscle density, the total SPPB score of those with myosteatosis was 1.57 points lower (p = 0.0008), HGS was 0.85 kg lower (p = 0.73), and TUG took 1.34 s longer (p = 0.03). There were no differences in women.

Conclusion

Myosteatosis is associated with physical function prior to treatment in HNC patients. Larger studies are needed to examine the importance of exercise programs prior to and during treatment to build lean mass and improve long-term prognosis in HNC.

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Data availability

Shaver, Platek, and Singh had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. The data underlying this article cannot be shared publicly for the privacy of individuals that participated in the study.

Code availability

All analyses were completed using SAS version 9.4.

References

  1. Siegel RL et al (2021) Cancer statistics, 2021. CA: Cancer J Clin 71(1):7–33

    Google Scholar 

  2. Lucas AR et al (2020) Trajectories in muscular strength and physical function among men with and without prostate cancer in the health aging and body composition study. PLoS One 15(2):e0228773

    Article  CAS  Google Scholar 

  3. Correa-de-Araujo R et al (2020) Myosteatosis in the context of skeletal muscle function deficit: an interdisciplinary workshop at the national institute on aging. Front Physiol 11:963–963

    Article  Google Scholar 

  4. Prado CMM, Heymsfield SB (2014) Lean tissue imaging: a new era for nutritional assessment and intervention. JPEN J Parenteral Enteral Nutr 38(8):940–953

    Article  Google Scholar 

  5. Shen W et al (2004) Total body skeletal muscle and adipose tissue volumes: estimation from a single abdominal cross-sectional image. J Appl Physiol (1985) 97(6):2333–8

    Article  Google Scholar 

  6. Findlay M et al (2020) Sarcopenia and myosteatosis in patients undergoing curative radiotherapy for head and neck cancer: Impact on survival, treatment completion, hospital admission and cost. J Hum Nutr Diet 33(6):811–821

    Article  CAS  Google Scholar 

  7. Farrugia M et al (2021) Change in physical performance correlates with decline in quality of life and frailty status in head and neck cancer patients undergoing radiation with and without chemotherapy. Cancers (Basel) 13(7):1638

    Article  Google Scholar 

  8. Brown JC, Harhay MO, Harhay MN (2015) Physical function as a prognostic biomarker among cancer survivors. Br J Cancer 112(1):194–198

    Article  CAS  Google Scholar 

  9. Perera S et al (2006) Meaningful change and responsiveness in common physical performance measures in older adults. J Am Geriatr Soc 54(5):743–749

    Article  Google Scholar 

  10. Pavasini R et al (2016) Short physical performance battery and all-cause mortality: systematic review and meta-analysis. BMC Med 14(1):215

    Article  Google Scholar 

  11. Barbat-Artigas S et al (2013) Muscle quantity is not synonymous with muscle quality. J Am Med Dir Assoc 14(11):852.e1-852.e8527

    Article  Google Scholar 

  12. Martín-Ponce E et al (2014) Prognostic value of physical function tests: hand grip strength and six-minute walking test in elderly hospitalized patients. Sci Rep 4:7530–7530

    Article  Google Scholar 

  13. Cruz-Jentoft AJ 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. Age Ageing 48(1):16–31

    Article  Google Scholar 

  14. Cesari M et al (2009) Added value of physical performance measures in predicting adverse health-related events: results from the health, aging and body composition study. J Am Geriatr Soc 57(2):251–259

    Article  Google Scholar 

  15. Bohannon RW (2019) Grip strength: an indispensable biomarker for older adults. Clin Interv Aging 14:1681–1691

    Article  CAS  Google Scholar 

  16. Forrest KYZ et al (2018) Patterns and correlates of grip strength in older Americans. Curr Aging Sci 11(1):63–70

    Article  Google Scholar 

  17. Ha Y-C et al (2018) Hand grip strength measurement in different epidemiologic studies using various methods for diagnosis of sarcopenia: a systematic review. European Geriatric Medicine 9(3):277–288

    Article  Google Scholar 

  18. Bischoff HA et al (2003) Identifying a cut-off point for normal mobility: a comparison of the timed ‘up and go’test in community-dwelling and institutionalised elderly women. Age Ageing 32(3):315–320

    Article  Google Scholar 

  19. Cruz-Jentoft AJ et al (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48(1):16–31

    Article  Google Scholar 

  20. Huisman MG et al (2014) “Timed Up & Go”: a screening tool for predicting 30-day morbidity in onco-geriatric surgical patients? A multicenter cohort study. PloS one 9(1):e86863–e86863

    Article  Google Scholar 

  21. Agmon M, Armon G (2016) A cross-sectional study of the association between mobility test performance and personality among older adults. BMC Geriatr 16(1):105

    Article  Google Scholar 

  22. Lydiatt W, O’Sullivan B, Patel S (2018) Major changes in head and neck staging for 2018. Am Soc Clin Oncol Educ Book 38:505–514

    Article  Google Scholar 

  23. Amin M et al (2017) AJCC cancer staging manual, 8th edn. Springer, New York

    Book  Google Scholar 

  24. Valentine RJ et al (2009) Sex impacts the relation between body composition and physical function in older adults. Menopause (New York, N.Y.) 16(3):518–523

    Article  Google Scholar 

  25. Tseng LA et al (2014) Body composition explains sex differential in physical performance among older adults. J Gerontol Ser A Biol Sci Med Sci 69(1):93–100

    Article  Google Scholar 

  26. Siegel RL, Miller KD, Jemal A (2020) Cancer statistics, 2020. CA: Cancer J Clin 70(1):7–30

    Google Scholar 

  27. Fryar CD et al (2018) Mean body weight, height, waist circumference, and body mass index among adults: United States, 1999–2000 through 2015–2016. Natl Health Stat Report 122:1–16

    Google Scholar 

  28. Starling S (2021) FAPs linked with muscle degeneration in T2DM. Nat Rev Endocrinol

  29. Justice JN et al (2018) Cellular senescence biomarker p16INK4a+ cell burden in thigh adipose is associated with poor physical function in older women. J Gerontol Ser A Biol Sci Med Sci 73(7):939–945

    Article  CAS  Google Scholar 

  30. Anderson DE et al (2015) Associations of computed tomography-based trunk muscle size and density with balance and falls in older adults. J Gerontol Ser A 71(6):811–816

    Article  Google Scholar 

  31. Barbalho ER et al (2019) Is skeletal muscle radiodensity able to indicate physical function impairment in older adults with gastrointestinal cancer? Exp Gerontol 125:110688

    Article  Google Scholar 

  32. Williams GR et al (2017) Skeletal muscle measures and physical function in older adults with cancer: sarcopenia or myopenia? Oncotarget 8(20):33658–33665

    Article  Google Scholar 

  33. Hicks GE et al (2005) Cross-sectional associations between trunk muscle composition, back pain, and physical function in the health, aging and body composition study. J Gerontol A Biol Sci Med Sci 60(7):882–887

    Article  Google Scholar 

  34. Duan-Porter W et al (2016) Physical resilience of older cancer survivors: an emerging concept. J Geriatr Oncol 7(6):471–478

    Article  Google Scholar 

  35. Muresan BT et al (2019) Measurement of body composition in cancer patients using CT planning scan at the third lumbar vertebra. Nutr Hosp 36(6):1307–1314

    PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to acknowledge Kelsey Smith, PA, for her tireless efforts to provide excellent care to these patients.

Funding

This work was supported by the National Cancer Institute Cancer Center Support Grant (5P30CA016056-42). ALS was funded by the National Cancer Institute Interdisciplinary Training in Cancer Epidemiology Grant (T32CA113951). Funding source had no role in study design, data collection, data analysis, data interpretation, or writing of the report.

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Authors and Affiliations

  1. Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA

    Amy L. Shaver, Katia Noyes & Heather M. Ochs-Balcom

  2. Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

    Amy L. Shaver, Mary E. Platek & Anurag K. Singh

  3. Department of Dietetics, D’Youville College, Buffalo, NY, 14203, USA

    Mary E. Platek

  4. Department of Epidemiology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

    Mary E. Platek, Kayleigh Erickson, Elizabeth Wendel & Andrew Ray

  5. Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA

    Gregory Wilding

  6. Department of Rehabilitation Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14203, USA

    Andrew Ray

Authors
  1. Amy L. Shaver
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  2. Katia Noyes
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Contributions

Conceptualization: A.L.S., A.D.R., M.E.P., and K.N.; methodology: A.L.S., G.W., H.O.B., A.D.R., and A.K.S.; software: A.K.S.; formal analysis: A.L.S.; resources: A.K.S., A.D.R., and M.E.P.; data curation: A.L.S., K.E., E.W., A.D.R., A.K.S., and M.E.P.; writing—original draft preparation: A.L.S., M.E.P., G.W., H.O.B., A.D.R., and K.N.; writing—review and editing: A.L.S., M.E.P., G.W., H.O.B., A.D.R., K.N., and A.K.S.; supervision: A.K.S., A.D.R., M.E.P., K.N.; project administration: A.L.S., A.D.R., K.N., M.E.P., and A.K.S.; funding acquisition: A.L.S., A.D.R., and A.K.S. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Amy L. Shaver.

Ethics declarations

Ethics approval

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board (or Ethics Committee) of Roswell Park Comprehensive Cancer Center (EDR-103707 2/28/2018 l).

Consent to participate

A waiver of consent was obtained from the Institutional Review Board due to the retrospective nature of the study making consent impractical and contacting patients to obtain consent would pose a greater risk than the waiver.

Consent for publication

Consent for publication was obtained.

Competing interests

The authors declare no competing interests.

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Shaver, A.L., Noyes, K., Platek, M.E. et al. Cross-sectional analysis of myosteatosis and physical function in pretreatment head and neck cancer patients. Support Care Cancer 30, 3401–3408 (2022). https://doi.org/10.1007/s00520-022-06808-x

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