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Pereira LMB, Ruas HMS, de Freitas Filho W, Alves WSM, Dias GO, Durães CP, Monteiro-Junior RS, Santos SHS, Farias LC, Guimarães ALS, Haikal DSA, Cardoso CM, de Paula AMB. Older adults, appendicular anthropometric measurements, and poor functional performance are predictors of sarcopenia in individuals with head and neck squamous cell carcinoma. Support Care Cancer 2024; 32:82. [PMID: 38175289 DOI: 10.1007/s00520-023-08254-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 12/11/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE To identify predictors of sarcopenia (demographical, anthropometric measurements, tumor-related clinical characteristics, performance status, and serum C-reactive protein (CRP) and albumin levels in individuals with head and neck squamous cell carcinoma (HNSCC). MATERIAL AND METHODS This cross-sectional study selected diagnosed with HNSCC (n = 125). Sarcopenia was defined as low muscle strength and low physical performance. Association between sarcopenia and anthropometric assessments (weight, height, body mass index, triceps skinfold, mid-upper arm circumference [MUAC], mid-upper arm muscle circumference, mid-upper arm fat area [UFA], mid-upper arm bone free muscle area, calf circumference, and appendicular skeletal muscle mass and index), tumor clinical characteristics (anatomical site, tumor size, and cervical metastasis), performance status scale (Eastern Cooperative Oncology Group Performance Status [ECOG-PS]), and CRP and albumin levels was analyzed using binary logistic regression models. RESULTS The diagnosis of sarcopenia was identified in 28 (22.4%) individuals with HNSCC. Being an older adult increases the odds of association with sarcopenia in individuals with HNSCC (odds ratio [OR] = 1.05). Increments in MUAC measurement reduce the odds of association with sarcopenia (OR = 0.69), while the increase in the UFA measurement increases the odds of association with sarcopenia (OR = 1.33). Poor ECOG-PS scores increase the odds of association with sarcopenia in individuals with HNSCC (OR = 5.54). CONCLUSION Early identification of easy-to-perform, cost-effective predictors of sarcopenia tends to favor the implementation of personalized therapeutic and supportive interventions in individuals with HNSCC.
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Affiliation(s)
- Luciana Mara Barbosa Pereira
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
| | - Hérika Maria Silveira Ruas
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
| | - Walter de Freitas Filho
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
| | - Wislene Sarajane Moreira Alves
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
- Head and Neck Surgery and Oncology Center, Fundação de Saúde Hospital Dilson de Quadros Godinho, Montes Claros, Minas Gerais, 39400-292, Brazil
| | - Gabrielle Oliveira Dias
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
| | - Cristina Paixão Durães
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
- Head and Neck Surgery and Oncology Center, Fundação de Saúde Hospital Dilson de Quadros Godinho, Montes Claros, Minas Gerais, 39400-292, Brazil
| | - Renato Sobral Monteiro-Junior
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
- Department of Physical Education, Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, Minas Gerais, 39401-001, Brazil
| | - Sérgio Henrique Sousa Santos
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
- Departament of Food Engineering, Institute of Agricultural Sciences, Universidade Federal de Minas Gerais (UFMG), Montes Claros, Minas Gerais, 39404-547, Brazil
| | - Lucyana Conceição Farias
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
- Department of Dentistry, Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, Minas Gerais, 39401-001, Brazil
| | - André Luiz Sena Guimarães
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
- Department of Dentistry, Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, Minas Gerais, 39401-001, Brazil
| | - Desirée Sant Ana Haikal
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
- Department of Dentistry, Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, Minas Gerais, 39401-001, Brazil
| | - Cláudio Marcelo Cardoso
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
- Head and Neck Surgery and Oncology Center, Fundação de Saúde Hospital Dilson de Quadros Godinho, Montes Claros, Minas Gerais, 39400-292, Brazil
| | - Alfredo Mauricio Batista de Paula
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil.
- Department of Dentistry, Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, Minas Gerais, 39401-001, Brazil.
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Tharakan T, Piccirillo JF, Miller B, Reed DR, Kallogjeri D, Paniello R, Puram SV, Jackson RS. Acute Taste Dysfunction in Oropharyngeal Cancer Patients after Transoral Robotic Surgery. Laryngoscope 2023; 133:3520-3528. [PMID: 37551882 PMCID: PMC10843268 DOI: 10.1002/lary.30939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/23/2023] [Accepted: 07/17/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVES To compare taste changes after transoral robotic surgery (TORS) to taste changes in healthy controls. METHODS Oropharyngeal cancer patients receiving TORS and healthy controls were recruited. Participants underwent posterolateral and whole-mouth psychophysical taste testing (identification, intensity, and hedonics) at baseline and at 2 weeks postoperatively (patients) or follow-up (controls). Surgeons reported suspension time and glossopharyngeal nerve injury (GNI) based on the identification and sacrifice of the nerve. A Clinical Global Impression (CGI) of taste symptoms was completed at each session ("My sense of taste bothers me" on a 5-point scale from Never [1] to Always [5]). A taste disorder (TD) was a CGI of 3 (Sometimes) or worse. Within-subject changes in CGI and psychophysical scores were computed. "Worsened taste" was a CGI increase by ≥1 point at follow-up. RESULTS Of 69 participants, most (33/37 tumor, 31/32 controls) had normal baseline taste (CGI < 3). 14/33 (42%) TORS patients and no controls developed new TDs at follow-up. More smokers (7/9) had worsened taste than nonsmokers (19/60, difference = 46% [95% CI 16%-76%]). More patients without GNI (6/22) than with GNI (0/15) had postoperative phantogeusia (difference = 27% [95% CI 9-45%]). Tumor-ipsilateral taste identification (TI) decreased more in patients (-11.3%) than controls (0.8%, difference = 12.2% [95% CI 5.0-19.3%]). Suspension time was not associated with worsened taste symptoms or psychophysical changes. CONCLUSIONS Patient-reported taste changes after TORS are frequent. Compared to healthy controls, TORS patients have decreased tumor-ipsilateral TI. Suspension time and GNI are unlikely to cause symptomatic TDs. Further investigations of the etiology and long-term symptom burden of TORS-associated TDs will aid in the management of oropharyngeal cancer patients. LEVEL OF EVIDENCE 3 (non-randomized controlled cohort study) Laryngoscope, 133:3520-3528, 2023.
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Affiliation(s)
- Theresa Tharakan
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Jay F. Piccirillo
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Brevin Miller
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
- School of Medicine, University of Missouri Kansas City, Kansas City, MO
| | | | - Dorina Kallogjeri
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Randall Paniello
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Sidharth V. Puram
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
- Department of Genetics, Washington University School of Medicine, St Louis, MO
| | - Ryan S. Jackson
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
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Zhu M, Wang T, Sun J, Zhou Z, Wang D, Teng L. Heterogeneity of vulnerability and taste changes in older cancer patients undergoing chemotherapy: a latent class analysis. Support Care Cancer 2023; 31:392. [PMID: 37310497 DOI: 10.1007/s00520-023-07862-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/04/2023] [Indexed: 06/14/2023]
Abstract
PURPOSE Taste changes and vulnerability are commonly co-occurring in oncology patients undergoing chemotherapy. However, few studies explored the association and the inter-individual variability of these two conditions. This study aimed to identify heterogeneous subtypes of vulnerability and taste changes in older cancer patients undergoing chemotherapy, and explore individuals' characteristics and risk factors. METHODS In this cross-sectional study, the latent class analysis (LCA) was conducted to identify the heterogeneous subgroups of patients with distinct vulnerability and taste change profiles. Differences in sociodemographic and clinical characteristics among the subpopulation were evaluated using parametric and nonparametric tests. Multinomial logistic regression was performed to investigate predictors of taste change-vulnerability subgroup classification. RESULTS Three subgroups of those older cancer survivors were identified from the LCA: Class 1 (27.5%)-"Moderate taste change and low vulnerability", Class 2 (29.0%)-"Low taste change and moderate vulnerability", Class 3 (43.5%)-"High taste change and high vulnerability". 98.9% of Class 3 reported taste changes and 54.0% reported vulnerability. Results from multinomial logistic regression indicated that patients in Class 3 were more likely to report experiencing mouth dryness and high blood pressure, and have received more than 3 cycles of chemotherapy. CONCLUSION The findings could provide new insights into the association between taste changes and vulnerability in older cancer adults receiving chemotherapy. Identifying different latent classes of taste changes and vulnerability would be helpful for developing interventions tailored to the heterogeneous survivors.
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Affiliation(s)
- Min Zhu
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Teng Wang
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Jun Sun
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Zhou Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Danhui Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Liping Teng
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China.
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