Michael Fattouh1, Gina Y Chang1, Thomas J Ow2,3, Keivan Shifteh4, Gregory Rosenblatt3, Viraj M Patel2, Richard V Smith2,3,5, Michael B Prystowsky3, Nicolas F Schlecht3,6,7,8. 1. Albert Einstein College of Medicine, Bronx, New York. 2. Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York. 3. Department of Pathology, Montefiore Medical Center, Bronx, New York. 4. Department of Radiology, Montefiore Medical Center, Bronx, New York. 5. Department of Surgery, Montefiore Medical Center, Bronx, New York. 6. Department of Medicine (Oncology), Montefiore Medical Center, Bronx, New York. 7. Department of Epidemiology & Population Health, Montefiore Medical Center, Bronx, New York. 8. Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York.
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.
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 HNSCCpatients 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/obesepatients 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-sarcopenicpatients, with the strongest association seen among overweight/obesepatients. CONCLUSION: Our data support the importance of sarcopenia assessment, in addition to BMI, among patients with HNSCC.
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