Impact of obesity on the survival of patients with early-stage squamous cell carcinoma of the oral tongue Journal Article


Authors: Iyengar, N. M.; Kochhar, A.; Morris, P. G.; Morris, L. G.; Zhou, X. K.; Ghossein, R. A.; Pino, A.; Fury, M. G.; Pfister, D. G.; Patel, S. G.; Boyle, J. O.; Hudis, C. A.; Dannenberg, A. J.
Article Title: Impact of obesity on the survival of patients with early-stage squamous cell carcinoma of the oral tongue
Abstract: 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/m2), overweight (25-29.9 kg/m2), or normal (18.5-24.9 kg/m2). 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. © 2013 American Cancer Society.
Keywords: obesity; body mass index; head and neck neoplasms; tongue neoplasms; prognosis; squamous cell carcinoma of the head and neck
Journal Title: Cancer
Volume: 120
Issue: 7
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2014-04-01
Start Page: 983
End Page: 991
Language: English
DOI: 10.1002/cncr.28532
PROVIDER: scopus
PMCID: PMC3961521
PUBMED: 24449483
DOI/URL:
Notes: Cancer -- Cited By (since 1996):2 -- Export Date: 2 June 2014 -- CODEN: CANCA -- Source: Scopus
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Citation Impact
MSK Authors
  1. Patrick Glyn Morris
    115 Morris
  2. Clifford Hudis
    894 Hudis
  3. Ronald A Ghossein
    351 Ghossein
  4. Jay O Boyle
    107 Boyle
  5. Snehal G Patel
    323 Patel
  6. David G Pfister
    304 Pfister
  7. Matthew G Fury
    101 Fury
  8. Luc Morris
    160 Morris
  9. Neil Mukund Iyengar
    85 Iyengar
  10. Alejandro   Pino
    2 Pino