Quality of Life and Functionality of Head and Neck Cancer Patients Are Diminished As a Function of Sarcopenia and Obesity

Abstract

Background: Health-related quality of life (QoL) is a measure that allows us to know the patient’s perception of well-being and how it is affected by their disease and treatments. In cancer patients, sarcopenia has been associated with low scores on various instruments used to assess the QoL; however, little information is available on the effects of sarcopenia and sarcopenic obesity on the QoL of patients with head and neck cancer (H&NC). Methods: In this cross-sectional study with 71 H&NC patients aged between 40 and 80 years, we describe the scores on the instruments EORTC QLQ C-30 and EORTC QLQ-H&N35 according to the sarcopenia phenotype (NSG, nonsarcopenic group; SG, sarcopenic group; and SOG, sarcopenic obesity group), hand-grip strength, gait speed, total lymphocyte count, albumin, cholesterol and C-reactive protein, and the relationships between these variables. Results: The prevalence of sarcopenia and sarcopenic obesity was 48% and 28%, respectively. The QoL analysis showed that NSG had higher scores on the physical functioning scale [NSG 93 (83–100); SG 73 (52–88); SOG 83 (53–93), P =.009] and lower scores on the fatigue scale [NSG 11 (0–22); S 39 (30–67); SOG 44 (14–56); P =.004]. The NSG had a higher hand-grip strength (31.1 kg) than SG (24.1 kg, P =.007) and SOG (26.3 kg, P =.001), and a lower C-reactive protein. The SG and SOG showed no differences between them. Conclusions: Patients with sarcopenia or sarcopenic obesity have lower physical performance and a higher level of fatigue than nonsarcopenic patients. This loss of function can maintain or worsen sarcopenia due to the patient’s self-restraint in physical exertion that encourages an increase in muscle tissue.