RESUMEN
PURPOSE: There have been few reports on the evaluation of cancer cachexia based on skeletal muscle mass index (SMI) in patients with head and neck cancer. PATIENTS AND METHODS: One hundred and ninety-two head and neck cancer patients were enrolled. In definitive and adjuvant chemoradiotherapy settings, clinical outcomes were compared between cachexia and non-cachexia patients. RESULTS: Forty patients were diagnosed with cachexia (20.8%). In the definitive setting, overall survival (OS) was significantly shorter in the cachexia group (3-year OS: 50.0% vs 88.5%; p < 0.01), and multivariate analysis identified UICC stage IV, baseline albumin of <4 and cachexia as poor prognostic factors. However, cachexia was not significant in the adjuvant setting. CONCLUSION: Cancer cachexia was negatively associated with prognosis in patients with HNC who received definitive chemoradiotherapy. Nutritional intervention during chemoradiotherapy may improve survival in these patients.
RESUMEN
Decompressive laminoplasty with spinous process osteotomy (LSPO) was developed as a less invasive procedure for lumbar decompression by Weiner et al. There are few reports extensively highlighting the surgical outcomes of LSPO. The purpose of this study was to evaluate the surgical outcomes of LSPO for lumbar spinal stenosis (LSS). In total, 23 patients with LSS were studied. All patients were followed up for more than 2 years. The Japanese Orthopedic Association (JOA) scores, the recovery rate (RR) of JOA scores, Visual analog scale (VAS) scores, responses to the JOA Back Pain Evaluation Questionnaire (JOABPEQ), sagittal alignment and segmental motion following LSPO were assessed preoperatively and 2 years postoperatively. Postoperative paravertebral muscle atrophy and bone union rates between the spinous process and the residual laminae were assessed. Preoperative and 2-year postoperative JOA scores were 13.0 points and 24.7 points, respectively (p<0.001). With respect to JOABPEQ, significant improvements were observed in pain-related disorders (p<0.05), walking ability (p<0.01), social life function (p<0.05), and mental health (p<0.05) dimensions. There were no significant differences between preoperative and 2-year postoperative sagittal alignment and range of motion. The degree of the paravertebral muscle atrophy at 2 years postoperatively was 23.0 % at spread side and 9.6 % at nonspread side (p<0.01). The fusion rate of the spinous process with the arcus vertebrae was 87%. This result reveals that LSPO could acquire the reconstruction of posterior supporting structures. We demonstrated that LSPO could be a one of the surgical options for LSS.