Histopathologic Features of Mucosal Head and Neck Cancer Cachexia

• Published in: International journal of surgical oncology 2024-06, Vol.2024 (1), p.5339292
• Main Authors: Jones, Alexander J, Novinger, Leah J, Bonetto, Andrea, Davis, Kyle P, Giuliano, Marelle M, Mantravadi, Avinash V, Sim, Michael W, Moore, Michael G, Yesensky, Jessica A
• Format: Article
• Language: English
• Subjects: Aged; Albumin; Analysis; Body mass index; Cachexia; Cachexia - etiology; Cachexia - pathology; Cancer therapies; Chemotherapy; Comorbidity; Enteral nutrition; Female; Free Tissue Flaps; Head & neck cancer; Head and neck cancer; Head and Neck Neoplasms - complications; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - surgery; Hemoglobin; Humans; Larynx; Male; Middle Aged; Musculoskeletal system; Neoplasm Invasiveness; Nutrition; Prognosis; Radiation therapy; Retrospective Studies; Sarcopenia; Squamous cell carcinoma; Squamous Cell Carcinoma of Head and Neck - complications; Squamous Cell Carcinoma of Head and Neck - pathology; Squamous Cell Carcinoma of Head and Neck - surgery; Tobacco; Tumors; Variables; Weight loss
• ISSN: 2090-1402; 2090-1410; 2090-1410
• DOI: 10.1155/2024/5339292

Determine the histopathologic features that correlate with head and neck cancer (HNC) cachexia. A single-institution, retrospective study was performed on adults with HPV-negative, mucosal squamous cell carcinoma of the aerodigestive tract undergoing resection and free flap reconstruction from 2014 to 2019. Patients with distant metastases were excluded. Demographics, comorbidities, preoperative nutrition, and surgical pathology reports were collected. Comparisons of histopathologic features and cachexia severity were made. The study included 222 predominantly male (64.9%) patients aged 61.3 ± 11.8 years. Cachexia was identified in 57.2% patients, and 18.5% were severe (≥15% weight loss). No differences in demographics were identified between the groups. Compared to control, patients with severe cachexia had lower serum hemoglobin ( =0.048) and albumin ( < 0.001), larger tumor diameter ( < 0.001), greater depth of invasion ( < 0.001), and elevated proportions of pT4 disease ( < 0.001), pN2-N3 disease ( =0.001), lymphovascular invasion ( =0.009), and extranodal extension ( =0.014). Multivariate logistic regression identified tumor size (OR [95% CI] = 1.36 [1.08-1.73]), oral cavity tumor (OR [95% CI] = 0.30 [0.11-0.84]), and nodal burden (OR [95% CI] = 1.16 [0.98-1.38]) as significant histopathologic contributors of cancer cachexia. Larger, more invasive tumors with nodal metastases and aggressive histologic features are associated with greater cachexia severity in mucosal HNC.