Prognostic evaluation of sarcopenia with radiological and laboratory parameters in geriatric head and neck cancer patients

The study aimed to investigate the effect of sarcopenia on survival by evaluating it with pre-treatment and post-treatment radiological and pre-treatment laboratory parameters in patients in the geriatric age group (≥ 65) who were diagnosed with head and neck cancer and received radiotherapy. 74 patients who were diagnosed and received radiotherapy (RT) at Kayseri City Training and Research Hospital between 2015 and 2024 were included in the study. The muscle areas at the C3 vertebra level were measured from the pre-treatment and post-treatment computed tomography images of the patients. These muscle area measurements were translated into L3 vertebral muscle area. The median overall survival (mOS) of the patients was 36 months. Skeletal muscle index (SMI) values were calculated and evaluated in three categories as pre-treatment (SMIpre), post-treatment (SMIpost) and pre-treatment and post-treatment difference (SMIdiff). While the mOS value of the SMIdiff < 0.46 group could not be accessed, the mOS value of the > 0.46 group was 59 months (p = 0.074). In multivariate Cox regression analysis, independent factors affecting survival were determined as SMIdiff, lymph node involvement, and RT intention (p values: 0.027, 0.006, and 0.047 respectively). The importance of nutrition both before and during treatment in this age group, which is more prone to malnutrition, is supported by our study, which has a limited number of patients. To the best of our knowledge, the effect of SMIdiff value on survival before and after treatment and the evaluation of PNI in patients with geriatric head and neck cancer are shown for the first time in the literature.