{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T12:22:27Z","timestamp":1771676547189,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,2,14]],"date-time":"2021-02-14T00:00:00Z","timestamp":1613260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 108-2314-B-182A-018-MY3"],"award-info":[{"award-number":["MOST 108-2314-B-182A-018-MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Chang Gang Memorial Hospital","award":["CMRPG2E0101-CMRPG2E0103"],"award-info":[{"award-number":["CMRPG2E0101-CMRPG2E0103"]}]},{"name":"Chang Gang Memorial Hospital","award":["CMRPG2J0171"],"award-info":[{"award-number":["CMRPG2J0171"]}]},{"name":"Chang Gang Memorial Hospital","award":["CORPG2F0011-13"],"award-info":[{"award-number":["CORPG2F0011-13"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: This study investigates whether the appendicular skeletal muscle index (ASMI) was an independent prognostic predictor for patients with locally advanced head and neck cancer (LAHNC) receiving concurrent chemoradiotherapy (CCRT) and whether there were any differences in lean mass loss in different body regions during CCRT. Methods: In this prospective study, we analyzed the clinicopathological variables and the total body composition data before and after treatment. The factors associated with the 2-year recurrence-free survival rate (RFSR) were analyzed via logistic regression analysis. Results: A total of 98 patients were eligible for analysis. The body weight, body mass index, and all parameters of body composition significantly decreased after CCRT. The pretreatment ASMI was the only independent prognostic factor for predicting the 2-year RFSR (hazard ratio, 0.235; 95% confidence interval, 0.062\u20130.885; p = 0.030). There was at least 5% reduction in total lean and fat mass (p &lt; 0.001); however, the highest lean mass loss was observed in the arms (9.5%), followed by the legs (7.2%), hips (7.1%), waist (4.7%), and trunk (3.6%). Conclusions: The pretreatment ASMI was the only independent prognostic predictor for the 2-year RFSR of LAHNC patients undergoing CCRT. Asynchronous loss of lean mass may be observed in different body parts after CCRT.<\/jats:p>","DOI":"10.3390\/diagnostics11020309","type":"journal-article","created":{"date-parts":[[2021,2,14]],"date-time":"2021-02-14T08:53:56Z","timestamp":1613292836000},"page":"309","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Role of the Appendicular Skeletal Muscle Index for Predicting the Recurrence-Free Survival of Head and Neck Cancer"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5572-7897","authenticated-orcid":false,"given":"Kun-Yun","family":"Yeh","sequence":"first","affiliation":[{"name":"Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, College of Medicine, Keelung &amp; Chang Gung University, Keelung 222, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4662-1235","authenticated-orcid":false,"given":"Hang Huong","family":"Ling","sequence":"additional","affiliation":[{"name":"Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, College of Medicine, Keelung &amp; Chang Gung University, Keelung 222, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1842-6179","authenticated-orcid":false,"given":"Shu-Hang","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou &amp; Chang Gung University, Taoyuan City 333, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Hsu","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, College of Medicine, Keelung &amp; Chang Gung University, Keelung 222, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5006-0277","authenticated-orcid":false,"given":"Pei-Hung","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, College of Medicine, Keelung &amp; Chang Gung University, Keelung 222, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0361-4548","authenticated-orcid":false,"given":"Wen-Chi","family":"Chou","sequence":"additional","affiliation":[{"name":"Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, College of Medicine, Linkou &amp; Chang Gung University, Taoyuan City 333, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fang-Ping","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, College of Medicine, Keelung &amp; Chang Gung University, Keelung 222, Taiwan"},{"name":"Healthy Aging Research Center, Chang Gung University, Taoyuan City 333, Taiwan"},{"name":"Osteoporosis Prevention and Treatment Center, Chang Gung Memorial Hospital, Keelung 222, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2318-8507","authenticated-orcid":false,"given":"Yu-Ching","family":"Lin","sequence":"additional","affiliation":[{"name":"Osteoporosis Prevention and Treatment Center, Chang Gung Memorial Hospital, Keelung 222, Taiwan"},{"name":"Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, College of Medicine, Keelung &amp; Chang Gung University, Keelung 222, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2189","DOI":"10.1002\/cncr.21013","article-title":"Body composition and time course changes in regional distribution of fat and lean tissue in unselected cancer patients on palliative care\u2014Correlations with food intake, metabolism, exercise capacity, and hormones","volume":"103","author":"Fouladiun","year":"2005","journal-title":"Cancer"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/j.critrevonc.2013.06.003","article-title":"Malnutrition assessment in patients with cancers of the head and neck: A call to action and consensus","volume":"88","author":"Dechaphunkul","year":"2013","journal-title":"Crit. 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