Adipose tissue characteristics as a new prognosis marker of patients with locally advanced head and neck cancer

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Carrilho, Larissa Ariel Oliveira ; Juliani, Fabiana Lascala ; Moreira, Rafaella Caroline de Lellis ; Guerra, Livia Dias ; Santos, Fernanda Silva ; Padilha, Daniela Morais de Holanda ; Branbilla, Sandra Regina ; Horita, Vivian Naomi ; Novaes, Davi Magalhaes Leite ; Antunes-Correa, Ligia Macedo ; Lima, Carmem Silvia Passos ; Mendes, Maria Carolina Santos ; Carvalheira, Jose Barreto Campello

• Tipo de documento: Artigo Científico
• Fonte: FRONTIERS IN NUTRITION; v. 12, p. 11-pg., 2025-03-14.

Resumo

Background Patients with head and neck cancer (HNC) are at increased risk of malnutrition due to the presence of tumor and treatments. Body composition is a prognostic factor in these patients. However, the relationship between adipose tissue characteristics and survival in HNC is still unclear.Objective To evaluate the associations of adiposity, the radiodensity of adipose tissue and muscularity with the prognosis of patients with locally advanced HNC undergoing to chemoradiotherapy.Methods This retrospective study included 132 patients diagnosed with locally advanced HNC. Body composition assessment was performed using computed tomography (CT) images at the level of the third cervical vertebra (C3). The total adipose tissue radiodensity (TATR), the total adipose tissue index (TATI) and skeletal muscle index (SMI) were evaluated. The primary outcome was overall survival (OS).Results Patients in the highest TATI tertile had a lower risk of mortality when compared to those in the lowest tertile, HR: 0.56, 95% confidence Interval (CI): 0.32-0.96; p = 0.039. The highest TATR tertile was not associated with death. Patients with greater adiposity had a higher median survival compared to patients with medium and lower TATI (p = 0.0193). Individuals with lower TATI had lower energy intake than patients with higher TATI (p = 0.03). Additionally, patients with low muscularity had worse OS in the multivariable analysis (HR: 1.77, 95% CI: 1.01-3.07; p = 0.044).Conclusion In patients with locally advanced HNC, our findings underscore the significance of elevated adiposity, beyond maintained muscularity, as independent protective factors for overall survival. Our study highlights the critical importance of assessing body composition and initiating early nutritional interventions to improve the prognosis of these patients. (AU)

• Processo FAPESP: 21/10265-8 - Centro de Inovação Teranóstica em Câncer (CancerThera)
• Beneficiário: Carmino Antonio de Souza
• Modalidade de apoio: Auxílio à Pesquisa - Centros de Pesquisa, Inovação e Difusão - CEPIDs
• Processo FAPESP: 22/06239-4 - Avaliação do perfil genético tumoral, metabólico e inflamatório em pacientes com câncer colorretal: Insights a partir da avaliação do tecido adiposo
• Beneficiário: José Barreto Campello Carvalheira
• Modalidade de apoio: Auxílio à Pesquisa - Regular