Pretreatment fat‐free mass index correlates with early death in patients with head and neck squamous cell carcinoma

Abstract

BackgroundA significant proportion of patients with head and neck squamous cell carcinoma (HNSCC) are malnourished at diagnosis. In this study, we investigated how pretreatment body mass index (BMI) and fat‐free mass index (FFMI) correlate with early death, and whether these measurements are useful markers of prognosis for risk stratification of head and neck cancer patients.MethodsPatients (n = 404) with newly diagnosed, curable HNSCC and WHO performance status 0–2 were prospectively included and met with a study representative before treatment initiation, as well as up to four follow‐up visits. All patients provided an estimate of body weight at 6 months prior to diagnosis. Bioelectrical impedance analysis (BIA) was performed for all patients before treatment initiation.ResultsMost patients had oropharyngeal (46%), oral cavity (28%), or laryngeal cancer (12%). Forty‐five (11%) patients met the standardized criteria for malnutrition according to the Global Leadership Initiative on Malnutrition (GLIM) at diagnosis. FFMI at diagnosis was lower in patients who died within 6 and 12 months after the start of treatment than in patients who survived these time points (p = 0.035 and p = 0.005, respectively).ConclusionsIn this study, pretreatment FFMI was an independent prognostic factor for death within 6 and 12 months after the start of treatment in patients with HNSCC. Pretreatment BMI was not an independent risk factor for death within 6 and 12 months after treatment termination. Thus, FFMI may be useful for risk stratification of patients with head and neck cancer.