Impact of obesity on the survival of patients with early-stage squamous cell carcinoma of the oral tongue.
BACKGROUND
Although obesity increases risk and negatively affects survival for many malignancies, the prognostic implications in squamous cell carcinoma (SCC) of the oral tongue, a disease often associated with prediagnosis weight loss, are unknown.


METHODS
Patients with T1-T2 oral tongue SCC underwent curative-intent resection in this single-institution study. All patients underwent nutritional assessment prior to surgery. Body mass index (BMI) was calculated from measured height and weight and categorized as obese (≥ 30 kg/m(2) ), overweight (25-29.9 kg/m(2) ), or normal (18.5-24.9 kg/m(2) ). Clinical outcomes, including disease-specific survival, recurrence-free survival, and overall survival, were compared by BMI group using Cox regression.


RESULTS
From 2000 to 2009, 155 patients (90 men, 65 women) of median age 57 years (range, 18-86 years) were included. Baseline characteristics were similar by BMI group. Obesity was significantly associated with adverse disease-specific survival compared with normal weight in univariable (hazard ratio [HR] = 2.65, 95% confidence interval [CI] = 1.07-6.59; P = .04) and multivariable analyses (HR = 5.01; 95% CI = 1.69-14.81; P = .004). A consistent association was seen between obesity and worse recurrence-free survival (HR = 1.87; 95% CI = 0.90-3.88) and between obesity and worse overall survival (HR = 2.03; 95% CI = 0.88-4.65) though without reaching statistical significance (P = .09 and P = .10, respectively) in multivariable analyses.


CONCLUSIONS
In this retrospective study, obesity was an adverse independent prognostic variable. This association may not have been previously appreciated due to confounding by multiple factors including prediagnosis weight loss.
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York.
Neil M
NM
Iyengar
Amit
A
Kochhar
Patrick G
PG
Morris
Luc G
LG
Morris
Xi K
XK
Zhou
Ronald A
RA
Ghossein
Alejandro
A
Pino
Matthew G
MG
Fury
David G
DG
Pfister
Snehal G
SG
Patel
Jay O
JO
Boyle
Clifford A
CA
Hudis
Andrew J
AJ
Dannenberg
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009765:Obesity / Q000150:complications* / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D000077195:Squamous Cell Carcinoma of Head and Neck; D014062:Tongue Neoplasms / Q000150:complications* / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D055815:Young Adult
body mass index; head and neck neoplasms; obesity; prognosis; squamous cell carcinoma of the head and neck; tongue neoplasms