3418 - Association of Body Mass Index with Long Term Outcomes Among Patients with Head and Neck Cancer Who Received Upfront Surgery with or without Adjuvant Treatments
Presenter(s)
D. Alvarez1, M. Mallick2, V. Chennupati2, E. Gogineni3, S. Baliga4, D. J. Konieczkowski3, D. L. Mitchell3, S. R. Jhawar5, J. C. Grecula3, P. Bhateja6, L. Miller7, J. W. Rocco7, M. Bonomi6, D. M. Blakaj3, S. Zhu8, and S. J. Ma1; 1The Ohio State University, Columbus, OH, 2The Ohio State University College of Medicine, Columbus, OH, 3Department of Radiation Oncology, James Cancer Hospital/Wexner Medical Center, The Ohio State University, Columbus, OH, 4Department of Radiation Oncology, James Cancer Hospital, The Ohio State University Medical Center, Columbus, OH, 5Department of Radiation Oncology, The James Cancer Center, Ohio State University Wexner Medical Center, Columbus, OH, 6The Ohio State University Wexner Medical Center, Columbus, OH, 7The Ohio State University Department of Otolaryngology - Head & Neck Surgery, Columbus, OH, 8University of Florida, Gainesville, FL
Purpose/Objective(s):
Prior studies suggested that being overweight and obese were associated with favorable outcomes among patients with head and neck cancer who received chemoradiation or immunotherapy. However, there is a paucity of real-world, institutional studies reporting the association of body mass index (BMI) with long-term outcomes among patients who received upfront surgery with or without adjuvant treatments. We performed an observational cohort study of patients with head and neck cancer treated with upfront surgery followed by adjuvant radiation or chemoradiation.Materials/Methods:
A single-institution database was queried for patients with head and neck cancer diagnosed between December 2011 and December 2023 who underwent upfront surgery with or without adjuvant radiation or chemoradiation. Those with underweight BMI were excluded from our analysis due to small sample size. Cox multivariable analysis (MVA) and Fine-Gray MVA were performed to evaluate survival and oncologic outcomes, respectively. Interaction term analysis was performed between human papillomavirus (HPV) status and BMI. Bonferroni correction was performed for multiple comparisons, with p<0.025 considered statistically significant.Results:
A total of 822 patients were identified (n=257 [31.3%] with normal BMI; n=275 [33.5%] with overweight BMI; n=290 [35.3%] with obese BMI). Median follow up was 51.6 months (95% confidence interval [CI] 49.3-54.6). On Cox MVA, patients with obese BMI had better overall survival (OS; adjusted hazard ratio [aHR] 0.64, 95% CI 0.46-0.89, p=0.008) and progression-free survival (PFS; aHR 0.68, 95% CI 0.51-0.90, p=0.008), but not locoregional failure (LRF; aHR 0.92, 95% CI 0.62-1.37, p=0.68) and distant failure (DF; aHR 0.96, 95% CI 0.57-1.64, p=0.89) compared to those with normal BMI. There were no statistically significant differences for those with overweight BMI in both survival (OS: aHR 0.74, 95% CI 0.54-1.01, p=0.06; PFS: aHR 0.81, 95% CI 0.62-1.07, p=0.13) and oncologic outcomes (LRF: aHR 0.78, 95% CI 0.52-1.17, p=0.24; DF: 1.07, 95% CI 0.66-1.72, p=0.78) compared to those with normal BMI. Interaction term analyses were not statistically significant for OS (p=0.49), PFS (p=0.32), LRF (p=0.34), and DF (p=0.47).Conclusion:
Our real-world, institutional study suggested that obesity was an independent, favorable prognostic factor for survival, but not oncologic outcomes, among patients treated with upfront surgery for head and neck cancer, regardless of HPV status. Further studies are needed to evaluate the role of BMI among patients receiving surgical treatments for head and neck cancer.