title: Low body mass index at 3 months following adjuvant chemoradiation affects survival of postoperative locally advanced oral cavity cancer patients.
abstract: OBJECTIVE
  To investigate the association between body mass index and outcomes such as recurrence and survival in postoperative locally advanced oral cavity cancer patients who underwent adjuvant chemoradiation.
  
  
  METHODS
  Retrospective analysis of patient data and outcomes.
  
  
  METHODS
  We retrospectively analyzed the records of 61 stage III, IVA, and IVB oral cavity cancer patients who were treated with curative surgery and adjuvant chemoradiation between 2007 and 2009. Each patient's body mass index was recorded throughout the treatment duration and after its completion. The associations between demographic variables, body mass index, and survival outcomes were determined by univariate and multivariate analyses.
  
  
  RESULTS
  Overall, body mass index decreased throughout the chemoradiation period and reached the nadir at 3 months after completion of therapy. Univariate analysis showed that patients with body mass index <18.5 kg/m(2)  at 3 months after chemoradiation had significantly higher recurrence and decreased survival rates. Multivariate analysis confirmed that body mass index <18.5 kg/m(2)  at this time point is an independent predictor for recurrence (P = .039) and overall survival (P = .043).
  
  
  CONCLUSIONS
  Early recurrence can be predicted by malnourished status 3 months after treatment completion. Malnourishment has significant negative effects on overall survival in locally advanced postoperative oral cavity cancer patients who are undergoing adjuvant chemoradiation. After therapy is completed, nutritional guidance and care should be continued for patients with this advanced disease.
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: Pei-Hung
authors.initials: PH
authors.lastname: Chang
authors.forename: Cheng-Hsu
authors.initials: CH
authors.lastname: Wang
authors.forename: Jen-Seng
authors.initials: JS
authors.lastname: Huang
authors.forename: Chien-Hong
authors.initials: CH
authors.lastname: Lai
authors.forename: Tsung-Han
authors.initials: TH
authors.lastname: Wu
authors.forename: Yii-Jeng
authors.initials: YJ
authors.lastname: Lan
authors.forename: Jason Chien-Sheng
authors.initials: JC
authors.lastname: Tsai
authors.forename: Eric Yen-Chao
authors.initials: EY
authors.lastname: Chen
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Yang
authors.forename: Kun-Yun
authors.initials: KY
authors.lastname: Yeh
mesh_terms: D015992:Body Mass Index; D059186:Chemoradiotherapy, Adjuvant; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000453:epidemiology; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D009752:Nutritional Status; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome