Body mass index and prognosis in patients with head and neck cancer.
Body mass index (BMI) has been associated variably with head and neck cancer outcomes. We evaluated the association between BMI at either diagnosis or at early adulthood head and neck cancer outcomes.



Patients with invasive head and neck squamous cell cancer at Princess Margaret Cancer Centre in Toronto, Canada, were surveyed on tobacco and alcohol exposure, performance status, comorbidities, and BMI at diagnosis. A subset also had data collected for BMI at early adulthood.



With a median follow-up of 2.5 years, in 1279 analyzed patients, being overweight (hazard ratio [HR], 0.55; 95% confidence interval [CI], 0.4-0.8; p = .001) at diagnosis was associated with improved survival when compared with individuals with normal weight. In contrast, underweight patients at diagnosis were associated with a worse outcome (HR, 1.89; 95% CI, 1.2-3.1; p < .01).



Being underweight at diagnosis was an independent, adverse prognostic factor, whereas being overweight conferred better prognosis. BMI in early adulthood was not associated strongly with head and neck cancer outcomes. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1226-1233, 2017.
Head and Neck Surgery Department, Barretos Cancer Hospital, Barretos, Brazil.
Ricardo Ribeiro
0000-0003-4406-8958
RR
Gama
Biostatistics Department, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Yuyao
Y
Song
Biostatistics Department, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Qihuang
Q
Zhang
Department of Medicine, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
M Catherine
MC
Brown
Department of Otolaryngology and Head and Neck Surgery, University Health Network and University of Toronto, Toronto, Canada.
Jennifer
J
Wang
Department of Medicine, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Steven
S
Habbous
Department of Medicine, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Li
L
Tong
Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada.
Shao Hui
0000-0002-8072-4388
SH
Huang
Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada.
Brian
B
O'Sullivan
Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada.
John
J
Waldron
Biostatistics Department, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Wei
W
Xu
Department of Otolaryngology and Head and Neck Surgery, University Health Network and University of Toronto, Toronto, Canada.
David
D
Goldstein
Department of Medicine, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Geoffrey
G
Liu
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002173:Cancer Care Facilities; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D002423:Cause of Death; D015331:Cohort Studies; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D009864:Ontario; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis; D057170:Translational Research, Biomedical
body mass index; clinical outcomes; head and neck cancer; prognosis; squamous cell carcinoma