151751-Najiba-Chargi

404 CHAPTER 20 adverse health outcome, such as chemotherapy dose-limiting toxicity 14 , increased incidence of postoperative complications, and decreased survival. 15,16 The relation between low skeletal muscle mass, measured using CT of the head and neck, and frailty screeningmethods was recently reported by Zwart et al 11 . However, the direct relation of sarcopenia end CGA, as gold standard for frailty, has yet to be determined. Therefore, the aim of this study was to examine the association between sarcopenia, defined as the combination of low muscle strength and low muscle mass, and frailty, diagnosed by CGA. Our secondary aimwas to examine the association between sarcopenia and the frailty Fried criteria and the Groningen Frailty Indicator (GFI) frailty screening test. MATERIALS AND METHODS ETHICAL APPROVAL The design of this study was approved by the Medical Ethical Research Committee of the University Medical Center Utrecht (approval ID 17-365/C). All procedures in this study were in accordance with the ethical standards of the institutional and/or national research com- mittee and with the 1964 Helsinki declaration (Version 2008) and its later amendments or comparable ethical standards. All data were handled according to general data protection regulation (GDPR). PATIENTS AND STUDY DESIGN This study was designed as a single-center retrospective study. Older patients (≥70-years old) with pathologically proven head and neck squamous cell carcinoma (HNSCC) treated between April 2015 and February 2018 with routinely performed CGA, Fried Frailty criteria, GFI screening questionnaire, and pre-treatment CT or MRI during their diagnostic workup between April 2015 and February 2018. Histologic tumor types other than squamous cell carcinoma were excluded. Relevant demographic and clinical variables were collected from patient’s medical record: age at diagnosis, sex, body mass index (BMI), percentage of weight loss in 6 months prior to diagnosis, smoking status, alcohol use, nutritional status at diagnosis as evaluated by the Malnutrition Universal Screening Tool (MUST), comorbidities as evaluated by the Charlson comorbidity index (CCI), localization of the tumor, tumor type (primary, second primary or recurrence), and the TNM stage according the 8th edition of the UICC tumor classification of malignant tumors. SARCOPENIA Definition of sarcopenia Sarcopenia was defined as the combination of low MF, as determined by muscle strength, and low muscle quantity, as determined by SMM, according to the recommendation by the EWGSOP and further explained below. 13