Rationale: Patients with cancer of the upper gastrointestinal (GI) tract or lung are more likely to present with malnutrition at diagnosis than, for instance, patients with melanoma. Low muscle mass is an indicator of malnutrition and can be reliably determined by computed tomography (CT) analysis by skeletal muscle index (SMI) at the 3rd lumbar vertebra (L3) level. However, CT images at L3 are not always available. At each vertebrae level, we determined if diagnosis with head and neck cancer (HNC), oesophageal cancer (OC), or lung cancer (LC) was associated with lower SMI than diagnosis with melanoma (ME) in cancer patients from Belgium. Methods: Diagnostic CT images from adult patients with HNC, OC, LC or ME were included and analyzed. Scans were performed in the patients initial staging after diagnosis. MIM software version 7.0.1 was used to contour the muscle areas for all vertebrae levels. Skeletal muscle area was corrected for stature to calculate SMI (cm2/m2). We tested for the association of diagnosis with HNC, OC, or LC vs ME with SMI by univariate and multivariate linear regression analyses. In the multivariate analyses, age (years), sex, and body mass index (; kg/m2) were included as covariates. Betas (B; 95%CI) were calculated and statistical significance was set at p<0.05. Results: A total of 216 patients were included: 33 HNC, 44 OC and 52 LC patients (65.5±10.4y, 68% male, 24.2±4.8 kg/m2) vs. 87 ME patients (64.8±11.1y, 75% male, 28.8±7.0 kg/m2). Univariately, all levels except T2 and T3 were associated to a significantly lower SMI in HNC, OC, or LC patients vs. ME patients. B (95%CI) of the significant results varied from -12.37 (-16.19 - -8.55; C6) to -1.34 (-2.12- -0.55;C1). In the multivariate analyses, C2-C7, T2-T3, T5-T9 and L4 level showed a significantly lower SMI, and T2-T3 were associated with a significantly higher SMI in HNC, OC, or LC patients vs. ME patients. B (95%CI) of the significant results varied from -7.32 (-10.85- -3.80;C6) to 7.18 (3.77-10.59;T2). Conclusion: As expected in patients more likely to present with malnutrition, the diagnosis HNC, OC or LC was associated with significantly lower SMI at all vertebra levels, except T2 and T3. After correcting for differences in age, sex and between the groups, HNC, OC or LC still was associated with a lower SMI at most cervical and thoracic levels, but not at the lower thoracic and most lumbar levels.
|Status||Published - 1 dec. 2021|
|Evenement||ESPEN2021 - online|
Duur: 9 sep. 2021 → 14 sep. 2021
|Periode||9/09/21 → 14/09/21|