Body mass index and prognosis in patients with head and neck cancer

Abstract

Being underweight at diagnosis was an independent, adverse prognostic factor, whereas being overweight conferred better prognosis. BMI in early adulthood was not associated strongly with head and neck cancer outcomes. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1226-1233, 2017.

Association between pretreatment obesity, sarcopenia, and survival in patients with head and neck cancer

“…[8][9][10][11] Albergotti et al conducted a retrospective review of 300 patients with HPV positive oropharyngeal HNSCC and found that patients with a BMI less than 25 kg/m 2 had significantly shorter overall and disease-specific survival than their overweight counterparts. [13][14][15] The prevalence of sarcopenia varies based on a number of factors, including race, sex, and BMI. [13][14][15] The prevalence of sarcopenia varies based on a number of factors, including race, sex, and BMI.…”

“…24 Sarcopenia, however, may be a mediating factor for these findings, as studies suggest that sarcopenia may be associated with poor cancer survival. 13,14,25 Prevalence has been shown to be higher among normal-weight adults (40%) compared to obese adults (8%). 13,14,25 Prevalence has been shown to be higher among normal-weight adults (40%) compared to obese adults (8%).…”

“…14,22 An inverse association between BMI and sarcopenia was reported for patients with breast cancer with mean BMI increasing in patients with sarcopenia versus without. 13 Grossberg et al 28 showed that skeletal muscle depletion, both before and after radiotherapy, was associated with poorer overall survival in HNSCC patients. 9,27 Whereas loss of lean muscle mass can occur independently of BMI, the association between sarcopenia and poor overall survival may increase with BMI in patients with cancer.…”

“…To assess whether evidence of muscle depletion (sarcopenia) prior to treatment was also associated with survival in overweight/obese and normal-weight HNSCC patients, we conducted a nested case-control study of 113 patients with pretreatment abdominal computerized tomography (CT) scans collected within 6 months prior to treatment and up to 10 days after start of treatment using a measurement protocol outlined by Prado et al 13 HNSCC patients who died within 5 years of diagnosis were matched to surviving HNSCC patients on BMI group and tumor site using a nest-case control approach. This allowed us to efficiently sample cases with CT scans for assessment of sarcopenia.…”

Decreased gastrostomy tube incidence and weight loss after transoral robotic surgery for low‐ to intermediate‐risk oropharyngeal squamous cell carcinoma

“…Radiation dose may impact both weight loss and gastrostomy tube placement and, although this was analyzed in the current study, most patients who were treated with primary radiation received >60 Gy, thereby limiting our ability to analyze this variable. This study was not designed to evaluate disease‐specific outcomes but previous studies have examined the impact of baseline body mass index and peri‐treatment weight loss in the prognosis of head and neck cancer, yielding mixed results suggesting that depletion of skeletal muscle and low body mass index may be prognostic of poorer treatment outcomes …”