Prognostic Role of Preoperative Sarcopenia Evaluation of Cervical Muscles with Long-Term Outcomes of Patients with Oral Squamous Cell Carcinoma

SIMPLE SUMMARY: As sarcopenia has been shown to be associated with a variety of functional impairments and increased mortality, it has become increasingly important to evaluate sarcopenia comorbidity in oral squamous cell carcinoma (OSCC). We assessed sarcopenia in patients with OSCC in a way that is feasible in daily practice and retrospectively evaluated its impact on prognosis. Patients with both low quality and low quantity of cervical muscles had a significantly worse prognosis. Assessing sarcopenia by evaluating both the quality and quantity of preoperative cervical skeletal muscle mass may be useful in optimizing the treatment of patients with OSCC without requiring additional imaging or patient burden. ABSTRACT: Accumulating evidence has shown that sarcopenia in patients with oral squamous cell carcinoma (OSCC) is at a risk of poor prognosis. There is no universal consensus on how to assess sarcopenia in patients with OSCC in daily practice. It is important to validate the usefulness of sarcopenia assessment from cervical muscles, which are frequently used in routine clinical practice in patients with OSCC. In this study, we investigated whether preoperative lumbar (L3) skeletal muscle mass and adiposity in OSCC patients were associated with cervical (C3) skeletal muscle mass and adiposity from CT measurements. We also investigated whether skeletal muscle mass and adiposity in the C3 muscles were associated with survival rates in patients with OSCC. We demonstrated that both the quality and quantity of muscle between the C3 and L3 levels were positively correlated with each other. We also demonstrated that the survival rates in patients with low sternocleidomastoid muscle mass index, high processus spinosus muscle-intramuscular adipose tissue content, and the combination of both were significantly lower than those in the controls. These results suggest that the assessment of sarcopenia from multiple neck muscles by preoperative CT measurements may be useful in predicting the prognosis of patients with OSCC.