Association between pretreatment obesity, sarcopenia, and survival in patients with head and neck cancer

Michael Fattouh; Gina Y. Chang; Thomas J. Ow; Keivan Shifteh; Gregory Rosenblatt; Viraj M. Patel; Richard V. Smith; Michael B. Prystowsky; Nicolas F. Schlecht

doi:10.1002/hed.25420

Association between pretreatment obesity, sarcopenia, and survival in patients with head and neck cancer

Michael Fattouh, Gina Y. Chang, Thomas J. Ow, Keivan Shifteh, Gregory Rosenblatt, Viraj M. Patel, Richard V. Smith, Michael B. Prystowsky, Nicolas F. Schlecht

Research output: Contribution to journal › Article › peer-review

23 Scopus citations

Abstract

Background: Body mass index (BMI), sarcopenia, and obesity-related comorbidities have been associated with head and neck squamous cell carcinoma (HNSCC) progression. Methods: We conducted a retrospective analysis of 441 normal-weight, overweight, and obese HNSCC patients treated at Montefiore Medical Center (New York). Patients were grouped by BMI prior to treatment and assessed for differences in survival adjusting for comorbid conditions (cardiovascular disease and diabetes). Evidence of sarcopenia was also assessed using pretreatment abdominal CT scans in a subset of 113 patients. Results: Prior to treatment, 55% of HNSCC patients were overweight or obese. Overweight/obese patients had significantly better overall survival (hazard ratio [HR] = 0.4, 95% CI: 0.3-0.6) compared to normal-weight patients, independent of comorbid conditions. Patients with sarcopenia had significantly poorer survival (HR = 2.1, 95% CI: 1.1-3.9) compared to non-sarcopenic patients, with the strongest association seen among overweight/obese patients. Conclusion: Our data support the importance of sarcopenia assessment, in addition to BMI, among patients with HNSCC.

Original language	English (US)
Pages (from-to)	707-714
Number of pages	8
Journal	Head and Neck
Volume	41
Issue number	3
DOIs	https://doi.org/10.1002/hed.25420
State	Published - Mar 1 2019

Keywords

body mass index
epidemiology
obesity
sarcopenia
survival

ASJC Scopus subject areas

Otorhinolaryngology

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10.1002/hed.25420

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Association between pretreatment obesity, sarcopenia, and survival in patients with head and neck cancer. / Fattouh, Michael; Chang, Gina Y.; Ow, Thomas J.; Shifteh, Keivan; Rosenblatt, Gregory; Patel, Viraj M.; Smith, Richard V.; Prystowsky, Michael B.; Schlecht, Nicolas F.

In: Head and Neck, Vol. 41, No. 3, 01.03.2019, p. 707-714.

Research output: Contribution to journal › Article › peer-review

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title = "Association between pretreatment obesity, sarcopenia, and survival in patients with head and neck cancer",

abstract = "Background: Body mass index (BMI), sarcopenia, and obesity-related comorbidities have been associated with head and neck squamous cell carcinoma (HNSCC) progression. Methods: We conducted a retrospective analysis of 441 normal-weight, overweight, and obese HNSCC patients treated at Montefiore Medical Center (New York). Patients were grouped by BMI prior to treatment and assessed for differences in survival adjusting for comorbid conditions (cardiovascular disease and diabetes). Evidence of sarcopenia was also assessed using pretreatment abdominal CT scans in a subset of 113 patients. Results: Prior to treatment, 55% of HNSCC patients were overweight or obese. Overweight/obese patients had significantly better overall survival (hazard ratio [HR] = 0.4, 95% CI: 0.3-0.6) compared to normal-weight patients, independent of comorbid conditions. Patients with sarcopenia had significantly poorer survival (HR = 2.1, 95% CI: 1.1-3.9) compared to non-sarcopenic patients, with the strongest association seen among overweight/obese patients. Conclusion: Our data support the importance of sarcopenia assessment, in addition to BMI, among patients with HNSCC.",

keywords = "body mass index, epidemiology, obesity, sarcopenia, survival",

author = "Michael Fattouh and Chang, {Gina Y.} and Ow, {Thomas J.} and Keivan Shifteh and Gregory Rosenblatt and Patel, {Viraj M.} and Smith, {Richard V.} and Prystowsky, {Michael B.} and Schlecht, {Nicolas F.}",

note = "Funding Information: This project is supported in part by NIH grants CA115243 and DE023941 (to Nicolas F. Schlecht), National Cancer Institute P30 grants to the Einstein Cancer Research Center (CA013330) and to Roswell Park Comprehensive Cancer Institute (CA016056), and the Departments of Otorhinolaryngology-Head & Neck Surgery, Radiology and Pathology, Albert Einstein College of Medicine, Montefiore Medical Center. Thomas J. Ow's contribution was supported by a NIH K12 grant (CA132783) and a National Center for Advancing Translational Science (NCATS) grant (UL1TR001073; to the Einstein-Montefiore CTSA).",

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doi = "10.1002/hed.25420",

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AU - Chang, Gina Y.

AU - Ow, Thomas J.

AU - Shifteh, Keivan

AU - Rosenblatt, Gregory

AU - Patel, Viraj M.

AU - Smith, Richard V.

AU - Prystowsky, Michael B.

AU - Schlecht, Nicolas F.

N1 - Funding Information: This project is supported in part by NIH grants CA115243 and DE023941 (to Nicolas F. Schlecht), National Cancer Institute P30 grants to the Einstein Cancer Research Center (CA013330) and to Roswell Park Comprehensive Cancer Institute (CA016056), and the Departments of Otorhinolaryngology-Head & Neck Surgery, Radiology and Pathology, Albert Einstein College of Medicine, Montefiore Medical Center. Thomas J. Ow's contribution was supported by a NIH K12 grant (CA132783) and a National Center for Advancing Translational Science (NCATS) grant (UL1TR001073; to the Einstein-Montefiore CTSA).

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Background: Body mass index (BMI), sarcopenia, and obesity-related comorbidities have been associated with head and neck squamous cell carcinoma (HNSCC) progression. Methods: We conducted a retrospective analysis of 441 normal-weight, overweight, and obese HNSCC patients treated at Montefiore Medical Center (New York). Patients were grouped by BMI prior to treatment and assessed for differences in survival adjusting for comorbid conditions (cardiovascular disease and diabetes). Evidence of sarcopenia was also assessed using pretreatment abdominal CT scans in a subset of 113 patients. Results: Prior to treatment, 55% of HNSCC patients were overweight or obese. Overweight/obese patients had significantly better overall survival (hazard ratio [HR] = 0.4, 95% CI: 0.3-0.6) compared to normal-weight patients, independent of comorbid conditions. Patients with sarcopenia had significantly poorer survival (HR = 2.1, 95% CI: 1.1-3.9) compared to non-sarcopenic patients, with the strongest association seen among overweight/obese patients. Conclusion: Our data support the importance of sarcopenia assessment, in addition to BMI, among patients with HNSCC.

AB - Background: Body mass index (BMI), sarcopenia, and obesity-related comorbidities have been associated with head and neck squamous cell carcinoma (HNSCC) progression. Methods: We conducted a retrospective analysis of 441 normal-weight, overweight, and obese HNSCC patients treated at Montefiore Medical Center (New York). Patients were grouped by BMI prior to treatment and assessed for differences in survival adjusting for comorbid conditions (cardiovascular disease and diabetes). Evidence of sarcopenia was also assessed using pretreatment abdominal CT scans in a subset of 113 patients. Results: Prior to treatment, 55% of HNSCC patients were overweight or obese. Overweight/obese patients had significantly better overall survival (hazard ratio [HR] = 0.4, 95% CI: 0.3-0.6) compared to normal-weight patients, independent of comorbid conditions. Patients with sarcopenia had significantly poorer survival (HR = 2.1, 95% CI: 1.1-3.9) compared to non-sarcopenic patients, with the strongest association seen among overweight/obese patients. Conclusion: Our data support the importance of sarcopenia assessment, in addition to BMI, among patients with HNSCC.

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