The Clinical Value Of Evaluating OSCC.Patients' Nutriture By Using C3 SMI

ObjectiveTo explore the clinical value of C3 Skeletal Muscle Mass Index(C3 SMI)as a nutritive index for patients with oral squamous cell carcinoma(OSCC).MethodsIt was a retrospective investigation on the clinical data of 76 patients with primary OSCC who met inclusion criteria and received radical resection in NanFang Hospital affiliated to Southern Medical University from January 2012 to June 2018.The skeletal muscle cross-sectional area(CSA)on C3 vertebra including the sternocleidomastoid muscles(SCM)and the paravertebral muscles(PVM)were measured in the preoperative CT image using software PACS,setting the Hounsfield Unit range from-29 to +150HU.L3 CSA was gotten by the formula CSA at L3(m2)=24.078+2.789*CSA at C3(m2),and then L3 SMI calculated through the formula Skeletal Muscle Mass Index(L3 SMI)=L3 CSA/height2.According to the internationally recognized standards of sarcopenia,L3 SMI?52.4(cm2/m2)for male and L3 SMI?38.5(cm2/m2)for female,patients were divided into two groups:sarcopenia group and non-sarcopenia group.The diagnostic efficacy of C3 SMI in diagnosing sarcopenia of OSCC patients was evaluated by using the receiver operating characteristic curve(ROC).Finally,we investigate the clinical value of C3 SMI in predicting nutriture,3-year survival rate and 5-year survival rate of OSCC patients according to the clinical date.Result78 cases were enrolled in the study and 36 of them met the diagnostic criteria of sarcopenia.The incidence of sarcopenia was 46.15%that was significantly higher in male than female(65.45%vs 0%,p<0.001)and no significant difference in mean age between the sarcopenia group and the non-sarcopenia group(53.53±10.84 vs 55.48±10.26,p=0.579).The smoking index was significantly lower in the non-sarcopenia group than in the sarcopenia group(p<0.001).The L3 SMI and C3 SMI were 45.71±4.39cm2/m2,13.36±1.53cm2/m2 in sarcopenia group and 51.47±7.13cm2/m2,13.36±1.53cm2/m2 in non-sarcopenia group respectively(p=0.001 and 0.005).In advanced OSCC patients,sarcopenia was associated with postoperative complications(p=0.011)and length of postoperative hospital stay(p=0.033),but no significantly relationship with 3-year mortality and 5-year mortality(p=0.874 and 0.874)in this study.According to the ROC results,the diagnosing efficiency of C3 SMI in sarcopenia is higher in both sexes(C3 SMI ROC was 0.997 in male and 1.000 in female).Therefore,as the diagnostic index for sarcopenia,the cut-off point of C3 SMI:<15.313 cm2/m2 for male and?10.588 cm2/m2 for female should be instituted.ConclusionC3 SMI can be used as a diagnose index of sarcopenia in OSCC patients and the cut-off points are C3 SMI?15.313 cm2/m2 for male and C3 SMI?10.588 cm2/m2 for female;Sarcopenia may be associated with the postoperative complications and the length of postoperative hospital stay of the advanced OSCC patients,which indicated that nutritional support therapy may improve their life quality.