Evidence map›Paper›PMID 41815554›Full record

ArticleFrontiers in oncology2026

Muscle matters: automated CT-based body composition analysis predicts survival in patients with head and neck cancer treated with immunotherapy.

Frederic Jungbauer, Sonja Ludwig, Lena Huber, Annette Affolter, Anne Lammert, Nicole Rotter, Claudia Scherl, Elena Seiz, Farroch Vahidi Noghani, Stefan O Schönberg and 3 more

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Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Frederic JungbauerDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Sonja LudwigDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Lena HuberDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Annette AffolterDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Anne LammertDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Nicole RotterDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Claudia ScherlDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Elena SeizDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Farroch Vahidi NoghaniDepartment of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Stefan O SchönbergDepartment of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Johannes HauboldDepartment of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Clara ArndtDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Johannes M LudwigDepartment of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: The objective of this study was to evaluate the prognostic significance of CT-based body composition markers in patients with head and neck squamous cell cancer (HNSCC) treated with immunotherapy. Material and methods: Forty-five HNSCC patients (24.4% female, median age: 66 years) treated with Nivolumab or Pembrolizumab were retrospectively assessed. Automated body composition analysis was performed on thoracic CT scans. The analysis included skeletal muscle (SM), bone (B), visceral adipose tissue (VAT), and volumes of various adipose tissue compartments. Overall survival (OS) was estimated using the Kaplan-Meier method, and hazard ratios (HR) were calculated using the Cox proportional hazards model. In the multivariate analysis, the strongest body composition parameter was entered into the model. Results: The median OS was 8.13 months (95% CI: 4.8-21.9). Univariate analysis identified baseline high SM/B ratio, high (SM+VAT)/B ratio, albumin levels >3.4g/dl, low Eastern Cooperative Oncology Group (ECOG) performance status, body mass index ≥18.5 kg/m2, and male sex as significant prognostic factors for longer OS. In multivariate analysis, SM/B ratio (HR: 0.25, 95% CI: 0.1-0.64, p=0.004) and albumin ≤3.4 g/dl (HR: 0.31, 95% CI: 0.12-0.76, p=0.01) remained independent. Patients with both high SM/B and albumin survived the longest (median not reached) compared to either high SM/B or high albumin (9.6 months) vs. low SM/B and albumin (2.7 months). A decrease in SM/B of ≥ 8% after three months was associated with a lower median OS of 6.7 vs. 26.2 months, p=0.032. Conclusions: Automated CT-based body composition analysis, particularly the thoracic SM/B ratio and serum albumin level, provide valuable prognostic information on OS for HNSCC patients receiving immunotherapy and may guide clinical decision-making in this patient population.

Indexed as

body composition analysis (BCA)computed tomography (CT) imaginghead and neck squamous cell carcinoma (HNSCC)immunotherapysarcopenia

Identifiers

PMID41815554
PMCPMC12971423

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.