Relevance of sarcopenia in elderly patients undergoing surgery for oral squamous cell carcinoma

肌萎缩 医学 内科学 不利影响 队列 回顾性队列研究 基底细胞 队列研究 人口 并发症 外科 环境卫生
作者
Matin Ali Madadian,Lara Simoes Da Costa,Ashwin Kerai,Mandeep S. Bajwa,S.N. Rogers
出处
期刊:British Journal of Oral & Maxillofacial Surgery [Elsevier]
卷期号:62 (2): 184-190 被引量:2
标识
DOI:10.1016/j.bjoms.2023.11.017
摘要

Abstract

In the elderly population there is increasing evidence that frailty predicts adverse outcomes better than chronological age. Sarcopenia is an important component of frailty. This study aimed to establish the relevance of sarcopenia in elderly patients with oral squamous cell carcinoma (OSCC) undergoing surgery. This retrospective, single-centre, cohort study included patients over the age of 75 years who were diagnosed with OSCC between 2007 and 2016. Cross-sectional imaging of the neck was used to predict the Skeletal Muscle Index (SMI) using validated equations. Based on established thresholds, patients were categorised as having either a normal or low SMI, indicative of sarcopenia. Sixty-nine patients met the inclusion criteria. Patients with a low SMI had a longer length of stay (16.9 days vs 9.8 days, p = 0.030); they had more severe complications, defined as Clavien-Dindo grade IIIb or higher (17.6% vs 4.0%, p = 0.042); and their mean Comprehensive Complication Index (CCI) was also higher (14.1 vs 4.7, p = 0.051). Furthermore, 2/34 patients in the low SMI group died within 30 days of surgery compared with none in the normal SMI group (5.9% vs 0%, p = 0.503). Whilst patients with a low SMI who underwent surgery had lower five-year overall survival, the difference was not statistically significant. This study shows that sarcopenia negatively influences surgical outcomes in elderly patients. Routine measurement of SMI could be an indication for a comprehensive geriatric assessment (CGA).
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