title: Prognostic significance of body mass index before treatment for head and neck cancer.
abstract: BACKGROUND
  Patients with head and neck cancer frequently experience malnutrition. The purpose of this study was to examine the impact of nutritional status on prognosis and its association with treatment modalities.
  
  
  METHODS
  This retrospective study included 706 patients with head and neck cancer diagnosed between 2004 and 2012. The effects of pretreatment body mass index (BMI) on overall survival were analyzed using the Kaplan-Meier method and Cox regression model.
  
  
  RESULTS
  BMI ranged from 11.6 to 38.0 kg/m2 (median, 21.5) and was a prognostic factor for survival, independent of primary site, and tumor stage. The 5-year survival rates for underweight, normal, and overweight groups were 32.2%, 62.7%, and 73.5%, respectively. The hazard ratios of BMI in the surgery, chemoradiation, and radiation groups were 0.95, 0.91, and 0.79, respectively, and the latter two were statistically significant.
  
  
  CONCLUSIONS
  The impact of BMI is determined by the types of cancer treatment. Pretreatment BMI should be considered while deciding treatment.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Takenaka
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Takemoto
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Nakahara
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Yamamoto
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Toshimichi
authors.initials: T
authors.lastname: Yasui
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Atshushi
authors.initials: A
authors.lastname: Hanamoto
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Takahito
authors.initials: T
authors.lastname: Fukusumi
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Michiba
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Cho
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Inohara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000628:therapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate; D055815:Young Adult
keywords: body mass index, nutrition; head and neck; prognosis; squamous cell carcinoma