Identifying sarcopenia early in patients with oropharyngeal squamous cell carcinoma can help predict the need for feeding tube placement.
Detecting sarcopenia at baseline alongside markers of malnutrition could guide decision-making regarding the need for feeding tube placement in patients with oropharyngeal squamous cell carcinoma undergoing radiation or chemoradiation therapy.In patients with OPSCC, sarcopenia — progressive loss of skeletal muscle mass — is associated with worse survival, but whether pretreatment sarcopenia can predict functional outcomes, such as the need for feeding tube placement, is less clear.
Studies indicated that 33%-62% of patients with OPSCC undergoing radiotherapy receive feeding tubes to ensure sufficient dietary intake. But "no universally accepted protocol currently exists to guide the decision-making process for recommending" a feeding tube, experts explained. To determine whether sarcopenia can predict the need for a feeding tube, researchers reviewed 194 patients with OPSCC with a median age of 61 years, who received definitive radiotherapy or chemoradiotherapy at a tertiary care center between January 2013 and October 2017.
The researchers collected data on feeding tube placement, Performance Status Scale for Head and Neck Cancer normalcy of diet scores, and M.D. Anderson Dysphagia Inventory composite scores. The team assessed sarcopenia from CT imaging at the third cervical and fourth thoracic vertebrae levels and identified risk factors and optimal skeletal muscle index cutoff value for feeding tube placement.Overall, 60 patients received an enteral feeding tube; the median time to placement was 47 days from the date of the first multidisciplinary team consultation. Sarcopenia was identified at baseline in nearly 73% of patients based on C3 skeletal muscle mass measurements and in 41.
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