Predicting treatment intolerance in operable head and neck cancer using the modified head and neck surgery risk index
Marco A. Mascarella·Marie-Jeanne Kergoat·Keith Richardson·Varun Vendra·Mario Solari·Umamaheswar Duvvuri·Seungwon Kim·Shaum Sridharan·M. Kubik·Robert L. Ferris·Khalil Sultanem·Christina Tsien·George Shenouda·Nathaniel Bouganim·Khashayar Esfahani·Nader Sadeghi·Michael P. Hier·Alex Mlynarek
In 568 patients, including 343 in the derivation and 225 in the validation cohort, the mean age was 65 with 228 (40%) patients being frail and 259 (46%) sarcopenic. Treatment intolerance occurred in 270 (48%) patients. Independent predictors of treatment intolerance included low cervical paraspinal SMI, elevated Risk Analysis Index (RAI), reduced high-to-low attenuation SMI ratio and obesity. Sarcopenia and frailty had a synergistic effect on treatment intolerance. Adding cervical paraspinal SMI