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

Head Neck. 2019 Mar;41(3):707-714. doi: 10.1002/hed.25420. Epub 2018 Dec 23.

Abstract

Background: Body mass index (BMI), sarcopenia, and obesity-related comorbidities have been associated with head and neck squamous cell carcinoma (HNSCC) progression.

Methods: We conducted a retrospective analysis of 441 normal-weight, overweight, and obese HNSCC patients treated at Montefiore Medical Center (New York). Patients were grouped by BMI prior to treatment and assessed for differences in survival adjusting for comorbid conditions (cardiovascular disease and diabetes). Evidence of sarcopenia was also assessed using pretreatment abdominal CT scans in a subset of 113 patients.

Results: Prior to treatment, 55% of HNSCC patients were overweight or obese. Overweight/obese patients had significantly better overall survival (hazard ratio [HR] = 0.4, 95% CI: 0.3-0.6) compared to normal-weight patients, independent of comorbid conditions. Patients with sarcopenia had significantly poorer survival (HR = 2.1, 95% CI: 1.1-3.9) compared to non-sarcopenic patients, with the strongest association seen among overweight/obese patients.

Conclusion: Our data support the importance of sarcopenia assessment, in addition to BMI, among patients with HNSCC.

Keywords: body mass index; epidemiology; obesity; sarcopenia; survival.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Body Mass Index
  • Female
  • Head and Neck Neoplasms / complications*
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / therapy
  • Humans
  • Male
  • Middle Aged
  • Obesity / complications*
  • Retrospective Studies
  • Risk Factors
  • Sarcopenia / complications*
  • Squamous Cell Carcinoma of Head and Neck / complications*
  • Squamous Cell Carcinoma of Head and Neck / mortality*
  • Squamous Cell Carcinoma of Head and Neck / therapy
  • Survival Rate