Prognostic Value of Third Cervical Vertebra Skeletal Muscle Index in Oral Cavity Cancer: A Retrospective Study.

The Laryngoscope Pub Date : 2021-07-01 Epub Date: 2021-01-12 DOI:10.1002/lary.29390

Sheng-Wei Chang, Cheng-Ming Hsu, Yuan-Hsiung Tsai, Geng-He Chang, Ming-Shao Tsai, Ethan I Huang, Yao-Te Tsai

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引用次数: 9

Abstract

Objectives/hypothesis: To assess the prognostic utility of third cervical vertebra skeletal muscle index (C3 SMI) measured from preoperative head and neck computed tomography (CT) in patients with oral cavity squamous cell carcinoma (OSCC).

Study design: Retrospective study.

Methods: We retrospectively reviewed the medical records of 125 patients who underwent primary curative surgery for OSCC between 2009 and 2017. Their preoperative C3 SMI was calculated by adjusting the C3 cross-sectional area delineated on head and neck CT by body height squared. A Cox proportional hazard model was employed to identify prognostic factors, and a novel nomogram based on C3 SMI was built for individualized survival prediction.

Results: In Kaplan-Meier analysis, high C3 SMI was significantly associated with higher 5-year disease-free survival (DFS) and overall survival (OS) than low C3 SMI. In multivariate analysis, low C3 SMI was an independent risk factor for poor DFS and OS (hazard ratio [HR]: 2.197; 95% confidence interval [CI], 1.170-4.512, P = .032 and HR: 2.143; 95% CI, 1.232-3.728, P = .007, respectively). The concordance-index (C-index) of the nomogram based on C3 SMI was 0.814 for OS, higher than that of the nomogram based on tumor-node-metastasis staging alone (C-index = 0.731).

Conclusions: C3 SMI might serve as a novel prognosticator in OSCC patients undergoing curative surgery, and the nomogram based on C3 SMI might provide good prognostic discrimination ability for individualized survival prediction.

Level of evidence: IV Laryngoscope, 131:E2257-E2265, 2021.

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颈椎第三骨骼肌指数对口腔癌预后的回顾性研究。

目的/假设:评估术前头颈部计算机断层扫描(CT)测量的第三颈椎骨骼肌指数(C3 SMI)在口腔鳞状细胞癌(OSCC)患者中的预后价值。研究设计:回顾性研究。方法:我们回顾性回顾了2009年至2017年125例接受OSCC初步治疗手术的患者的医疗记录。术前C3 SMI通过调整头颈部CT上划定的C3截面积与身高的平方来计算。采用Cox比例风险模型识别预后因素，并基于C3 SMI建立新的nomogram进行个体化生存预测。结果:Kaplan-Meier分析显示，高C3 SMI患者的5年无病生存期(DFS)和总生存期(OS)显著高于低C3 SMI患者。在多变量分析中，C3 SMI低是DFS和OS差的独立危险因素(危险比[HR]: 2.197;95%置信区间[CI]， 1.170 ~ 4.512, P =。032, HR: 2.143;95% ci, 1.232 ~ 3.728, p =。007年,分别)。基于C3 SMI的OS nomogram一致性指数(C-index)为0.814，高于单纯基于肿瘤-淋巴结-转移分期nomogram (C-index = 0.731)。结论:C3 SMI可作为OSCC根治性手术患者的一种新的预后指标，基于C3 SMI的nomogram可为个体化生存预测提供良好的预后判别能力。证据水平:IV喉镜，131:E2257-E2265, 2021。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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The Laryngoscope

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