Skeletal muscle mass and inflammation-based prognostic score as prognostic factors in oral cancer.

Tumour-related malnutrition and impaired oral intake contribute to skeletal muscle loss in patients with oral cancer. The aim of this study was to examine the impact of pre-treatment skeletal muscle mass (SMM) and inflammation-based prognostic score (IBPS) on the prognosis of oral squamous cell carcinoma (OSCC). A total of 285 patients who underwent curative treatment for OSCC between 2010 and 2019 were included. SMM was evaluated as the cross-sectional area of the bilateral sternocleidomastoid muscles at the third cervical vertebra level (C3). IBPS included neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), prognostic nutritional index (PNI), and modified Glasgow prognostic score (mGPS). The prognosis was assessed by Kaplan-Meier survival analysis and Cox proportional hazards regression. The optimal SMM cut-off value was 644.0 mm2 for males and 381.0 mm2 for females. The optimal IBPS cut-off values were NLR ≥2.85, PLR ≥94.7, LMR <4.51, and PNI <48.21. Low SMM (P < 0.001), high NLR (P = 0.001), high PLR (P = 0.040), low LMR (P < 0.001), low PNI (P < 0.001), and mGPS of 1-2 (P < 0.001) were associated with significantly lower overall survival (OS). Multivariate analysis identified low SMM (P < 0.001), low albumin levels (P = 0.001), high NLR (P = 0.022), high PLR (P = 0.017), low LMR (P < 0.001), and low PNI (P = 0.001) as independent predictors of OS. In conclusion, low SMM and the IBPS predict poor OSCC outcomes.