Increased body mass index predicts prolonged survival in patients with head and neck squamous cell carcinoma

Wu, Eric; Peesay, Tejasvi; Randall, James A; Nelson, Lacey; Shearer, Sarah C; Johnson, Bria C.; Maxwell, Jessica H.

doi:10.1002/hed.26922

Cited by 5 publications

(9 citation statements)

References 32 publications

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“…They also tend to have lower tolerance to the toxicities of cancer treatment [24,27]. As shown in this study, the adverse impact of a low BMI exerts an additive effect, with acute hemorrhage in patients with HNC, leading to a worse overall survival.…”

Section: Discussionmentioning

confidence: 69%

Risk factors for rebleeding and long-term outcomes in patients with head and neck cancer bleeding: a multicenter study

Wang

Niu

et al. 2022

BMC Cancer

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Background Acute, catastrophic bleeding in patients with head and neck cancer (HNC) is challenging and also a burden for their families and frontline physicians. This study analyzed the risk factors for rebleeding and long-term outcomes in these patients with HNC. Methods Patients who presented to the emergency department (ED) with HNC bleeding were enrolled in this study (N = 231). Variables of patients with or without rebleeding were compared, and associated factors were investigated using Cox’s proportional hazard model. Results Of the 231 patients enrolled, 112 (48.5%) experienced a recurrent bleeding event. The cumulative rebleeding incidence rate was 23% at 30 days, 49% at 180 days, and 56% at 1 year. Multivariate Cox regression analyses demonstrated that overweight-to-obesity (HR = 0.52, 95% CI 0.28–0.98, p = 0.043), laryngeal cancer (hazard ratio [HR] = 2.13, 95% confidence interval [CI] 1.07–4.23, p = 0.031), chemoradiation (HR = 1.49, 95% CI 1.001–2.94, p = 0.049), and second primary cancer (HR = 1.75, 95% CI 1.13–2.70, p = 0.012) are significant independent predictors of rebleeding, and the prognostic factors for overall survival included underweight (HR = 1.89, 95% CI 1.22–2.93, p = 0.004), heart rate > 110 beats/min (HR = 1.58, 95% CI 1.04–2.39, p = 0.032), chemoradiation (HR = 2.31, 95% CI 1.18–4.52, p = 0.015), and local recurrence (HR = 1.74, 95% CI 1.14–2.67, p = 0.011). Conclusions Overweight-to-obesity is a protective factor, while laryngeal cancer, chemoradiation and a second primary cancer are risk factors for rebleeding in patients with HNC. Our results may assist physicians in risk stratification of patients with HNC bleeding.

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Section: Discussionmentioning

confidence: 69%

Risk factors for rebleeding and long-term outcomes in patients with head and neck cancer bleeding: a multicenter study

Wang

Niu

et al. 2022

BMC Cancer

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“…16,17 Veterans face unique challenges to care and have a disproportionate burden of comorbidities when compared to non-veteran populations. [18][19][20] Specifically, compared to the civilian population, veterans with HPVrelated HNSCC have higher rates of tobacco use and poor social support characteristics. 21,22 The high rate of comorbidities and variable support mechanisms among veterans place them at risk for poor outcomes when affected by a global pandemic.…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, HNSCC may confer increased risks of both venous and arterial thromboembolism 16,17 . Veterans face unique challenges to care and have a disproportionate burden of comorbidities when compared to non‐veteran populations 18–20 . Specifically, compared to the civilian population, veterans with HPV‐related HNSCC have higher rates of tobacco use and poor social support characteristics 21,22 .…”

Section: Discussionmentioning

confidence: 99%

The impact of COVID‐19 and vaccination status on outcomes in veterans with head and neck squamous cell carcinoma

Johns,

Choe,

Chisolm

et al. 2024

Head & Neck

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BackgroundThe impact of both COVID‐19 infection and vaccination status on patients with head and neck squamous cell carcinoma (HNSCC) remains unknown.ObjectiveTo determine the impact of COVID‐19 infection and vaccination status on 60‐day mortality, cardiovascular, and respiratory complications in patients with a prior diagnosis of HNSCC.MethodsThis was a retrospective cohort study through the Veterans Affairs (VA) Corporate Data Warehouse of Veterans with HNSCC who were tested for COVID‐19 during any inpatient VA medical center admission. A cohort of patients was created of Veterans with a diagnosis of HNSCC of the oral cavity,oropharynx, hypopharynx, larynx, and nasopharynx based on International Classification of Disease (ICD) codes. Data collected included clinical/demographic data, vaccination status, and incidence of 60‐day mortality, 60‐day cardiovascular complication (including myocardial infarction, venous thromboembolism, cerebrovascular accident), and 60‐day respiratory complication (including acute respiratory failure, acute respiratory distress syndrome, and pneumonia). The interactions between COVID‐19 infection, vaccination status, morbidity and mortality were investigated.ResultsOf the 14 262 patients with HNSCC who were tested for COVID‐19 during inpatient admission, 4754 tested positive (33.3%), and 9508 (67.7%) tested negative. Patients who tested positive demonstrated increased 60‐day mortality (4.7% vs. 2.0%, respectively; p < 0.001), acute respiratory failure (ARF; 15.4% vs. 7.1%, p < 0.001), acute respiratory distress syndrome (ARDS; 0.9% vs. 0.2%, p < 0.001), and pneumonia (PNA; 20.0% vs. 6.4%, p < 0.001) compared to those who never tested positive, respectively. Patients who received COVID‐19 vaccination between 2 weeks and 6 months prior to a positive test demonstrated decreased rates of ARF (13.2% vs. 16.0%, p = 0.034) and PNA (16.7% vs. 20.9%, p = 0.003) compared to the unvaccinated group. A logistic regression of patients with COVID‐19 infections who died within 60 days was performed, with no significant survival advantage among patients vaccinated between 2 weeks and 6 months prior to the positive test.ConclusionCOVID‐19 infection may significantly increase rates of 60‐day mortality and respiratory complications in patients with HNSCC. COVID‐19 vaccination between 2 weeks and 6 months prior to infection may decrease severity of respiratory complications but did not show significant mortality benefits in this study. These data highlight the need for surveillance of respiratory infection and vaccination in this vulnerable population.

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“…Although there have been several studies evaluating the association between body mass index (BMI) and SCCHN risk, [8][9][10][11][12][13] few studies have evaluated the association between BMI and clinical outcomes in patients with SCCHN, [14][15][16][17][18][19][20] and the findings of these studies have been mixed. [14][15][16][17][18][19][20] Some studies found significant associations between low BMI and worse survival among patients with oral squamous cell carcinoma 14 and SCCHN, 18 and other studies found significant associations between higher BMI and better survival among patients with SCCHN, 16,18,19 patients with SCCHN treated with radiation, 20 and veterans with SCCHN. 15 In contrast, one study found that obesity was an adverse independent prognostic factor in early-stage squamous cell carcinoma of the oral tongue.…”

Section: Introductionmentioning

confidence: 99%

“…[14][15][16][17][18][19][20] Some studies found significant associations between low BMI and worse survival among patients with oral squamous cell carcinoma 14 and SCCHN, 18 and other studies found significant associations between higher BMI and better survival among patients with SCCHN, 16,18,19 patients with SCCHN treated with radiation, 20 and veterans with SCCHN. 15 In contrast, one study found that obesity was an adverse independent prognostic factor in early-stage squamous cell carcinoma of the oral tongue. 17 Only a few studies have evaluated the association between BMI and clinical outcomes in patients with SCCHN stratified by tumor HPV status and subsite.…”

Section: Introductionmentioning

confidence: 99%

Impact of pretreatment body mass index on the survival of head and neck cancer patients

Yang,

Mansour,

Sun

et al. 2024

Head & Neck

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BackgroundDifferences in pretreatment body mass index (BMI) have been associated with survival in squamous cell carcinoma of head and neck (SCCHN). We examined effects of BMI on survival in SCCHN patients after stratifying patients by tumor human papillomavirus (HPV) status and subsite.MethodsTotally 2204 SCCHN patients in a prospective study were included in this secondary analysis. Multivariable Cox models were used to evaluate associations between pretreatment BMI and overall survival, disease‐specific survival, and disease‐free survival.ResultsBMI was significantly higher among patients with HPV‐positive tumors than HPV‐negative tumors. BMI >25 kg/m2 was associated with improved survival, while BMI <18.5 kg/m2 was associated with reduced survival, particularly in patients with HPV‐positive oropharyngeal cancer tumors.ConclusionsThis exploratory analysis suggests that pretreatment BMI could be an independent prognostic factor of survival outcomes in SCCHN patients, particularly in patients with HPV‐positive oropharyngeal cancer tumors. Further prospective investigations are warranted.

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Increased body mass index predicts prolonged survival in patients with head and neck squamous cell carcinoma

Cited by 5 publications

References 32 publications

Risk factors for rebleeding and long-term outcomes in patients with head and neck cancer bleeding: a multicenter study

Risk factors for rebleeding and long-term outcomes in patients with head and neck cancer bleeding: a multicenter study

The impact of COVID‐19 and vaccination status on outcomes in veterans with head and neck squamous cell carcinoma

Impact of pretreatment body mass index on the survival of head and neck cancer patients

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