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We used SM measures at the second thoracic vertebra (T2) to determine T2-SM index (SMI) thresholds for sarcopenia, and investigate the impact of low T2-SMI on overall survival (OS), and weight loss during radiotherapy (RT).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Adult patients with newly diagnosed HNC with a diagnostic PET\u2013CT or RT planning CT scan were included. SM was analysed at T2 and a model applied to predict SM at L3. T2-SMI thresholds for sarcopenia were established with predicted measures, stratified by BMI and sex. Impact of sarcopenia and low T2-SMI on OS and weight loss during RT was investigated.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 361 scans were analysed (84% males, 54% oropharynx tumours). Sarcopenia was found in 49%, demonstrating worse OS (<jats:italic>p<\/jats:italic>\u2009=\u20090.037). T2-SMI cutoff values were: females\u201474\u00a0cm<jats:sup>2<\/jats:sup>\/m<jats:sup>2<\/jats:sup> [area under the curve (AUC): 0.89 (95%CI 0.80\u20130.98)], males (BMI\u2009&lt;\u200925)\u201463\u00a0cm<jats:sup>2<\/jats:sup>\/m<jats:sup>2<\/jats:sup> [AUC 0.93 (95%CI 0.89\u20130.96)], males (BMI\u2009\u2265\u200925)\u201488cm<jats:sup>2<\/jats:sup>\/m<jats:sup>2<\/jats:sup> [AUC 0.86 (95%CI 0.78\u20130.93)]. No difference in OS with T2-SMI categories. Lowest T2-SMI quartile of\u2009&lt;\u200963\u00a0cm<jats:sup>2<\/jats:sup>\/m<jats:sup>2<\/jats:sup> demonstrated worse OS (<jats:italic>p<\/jats:italic>\u2009=\u20090.017). Weight loss during RT was higher in patients; who were not sarcopenic (6.2% vs 4.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.023); with higher T2-SMI (6.3% vs 4.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.014) and; in the highest quartiles (3.6% vs 5.7% vs 7.2%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>These T2-SMI thresholds are effective in assessing CT-defined sarcopenia in HNC. Further assessment of clinical application is warranted.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00405-023-08162-y","type":"journal-article","created":{"date-parts":[[2023,8,12]],"date-time":"2023-08-12T16:01:56Z","timestamp":1691856116000},"page":"5583-5594","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Thoracic skeletal muscle index is effective for CT-defined sarcopenia evaluation in patients with head and neck cancer"],"prefix":"10.1007","volume":"280","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1078-9212","authenticated-orcid":false,"given":"Belinda","family":"Vangelov","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Smee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Moses","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Bauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,8,12]]},"reference":[{"key":"8162_CR1","doi-asserted-by":"publisher","first-page":"394","DOI":"10.3322\/caac.21492","volume":"68","author":"F Bray","year":"2018","unstructured":"Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. 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