A Retrospective Cohort Study of Myosteatosis and Quality of Life in Head and Neck Cancer Patients

SIMPLE SUMMARY: Quality of life (QOL) is an important patient reported outcome that effects both care and life outside of treatment. There is a shortage of nontaxing ways to determine which patients may need enhanced care over the course of their therapy and beyond to help avoid long-term declines in QOL. Therefore, we investigated whether myosteatosis as determined through existing diagnostic imaging could be used to predict QOL trajectories. In this study, patients with pretreatment myosteatosis were more likely to have lower physical and global QOL scores than patients with normal muscle density. In conclusion, myosteatosis may be a way of determining patients in need of extra assistance over the course of treatment and afterwards. ABSTRACT: Head and neck cancer (HNC) treatment-related morbidity can be detrimental to quality of life (QOL). Myosteatosis is associated with poor QOL in multiple cancers. If predictive of poor QOL trajectories, myosteatosis would be a tool for clinicians to determine which patients may require additional support during treatment. The purpose of this study was to determine if pretreatment myosteatosis is associated with a poor QOL trajectory following treatment completion. Methods: In a retrospective cohort design, myosteatosis was determined from pretreatment CT scans. Both physical and global QOL score was assessed through patient interview on follow-up appointment. Demographic, cancer-specific, and social covariates were collected, reported, and considered as potential confounders. Results: The population of 163 patients was mostly male (82.2%) and white (91.4%) with oropharyngeal cancer (55.8%). Males with myosteatosis had a physical QOL score 46.84 points lower at one-year following treatment completion (p = 0.01) than those with normal muscle density (p = 0.01). Males with myosteatosis averaged 57.57 points lower at one-year post-treatment (p = 0.01) in global QOL scores. Conclusions: Over one year following completion of treatment, patients with myosteatosis reported worse physical and global QOL scores than patients with normal muscle density.