Impact of presarcopenic dysphagia on 1-year mortality after videofluoroscopic swallowing study in patients with cancer

Abstract Purpose Sarcopenic dysphagia is dysphagia due to low skeletal muscle mass and leads to increased pharyngeal residues. Presarcopenia is typified by low muscle mass without decreased muscle strength and physical function, unlike sarcopenia, and can also develop into dysphagia due to low skeletal muscle mass. This retrospective study aimed to investigate the impact of presarcopenic dysphagia on one-year mortality in patients with cancer who underwent a videofluoroscopic swallowing study because of dysphagia. Methods An operational definition of presarcopenic dysphagia based on presarcopenia and pharyngeal residues was adopted. The psoas muscle mass index (cm 2 /height 2 (m 2 )), calculated by the psoas muscle area at the L3 vertebra via abdominal computed tomography and related to height, was used to assess presarcopenia with cut-off levels of 4.62 for males and 2.66 for females. Pharyngeal residues were assessed using a videofluoroscopic swallowing study. Patients' medical charts were analyzed to investigate one-year mortality after a videofluoroscopic swallowing study. Results Out of 111 consecutive cancer patients, 53 (47.7%) were defined as having presarcopenic dysphagia. In a forward-stepwise Cox proportional regression analysis, presarcopenic dysphagia (HR 2.599; 95% CI 1.158–5.834) was significantly associated with one-year mortality after a videofluoroscopic swallowing study, even after adjusting for the factors of operation, Functional Oral Intake Scale at discharge, and modified Barthel Index scores at discharge. Conclusion Presarcopenic dysphagia, defined as computed tomography-based presarcopenia and pharyngeal residues observed during a videofluoroscopic swallowing study, is associated with increased one-year mortality in patients with cancer and dysphagia.