The effect of body mass index at diagnosis on survival of patients with squamous cell head and neck carcinoma

Roberta Pastorino, Denise Pires Marafon, Nicolò Lentini, Ilda Hoxhaj, Adriano Grossi, Luca Giraldi, Antonella Rondinò, Gabriella Cadoni, Jerry Polesel, Diego Serraino, Carlo La Vecchia, Werner Garavello, Cristina Canova, Lorenzo Richiardi, Jolanta Lissowska, Tamas Pandics, Tom Dudding, Andy Ness, Steve Thomas, Miranda PringKarl Kelsey, Michael McClean, Patrick Bradshaw, Zuo-Feng Zhang, Hal Morgenstern, Laura Rozek, Gregory Wolf, Andrew Olshan, Geoffrey Liu, Rayjean Hung, Marta Vilensky, Marcos Brasilino de Carvalho, Rossana Verónica Mendonza López, Victor Wunsch-Filho, Paolo Boffetta, Mia Hashibe, Yuan-Chin Amy Lee, Stefania Boccia

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

The aim of this study is to investigate the prognostic role of body mass index (BMI) on survival from head and neck cancer (HNC). We performed a pooled analysis of studies included in the International Head and Neck Cancer Epidemiology consortium. We used Cox proportional hazards models to estimate the adjusted hazard ratios (HR) for overall survival and HNC-specific survival, and we stratified the results according to cancer site. The study included 10,177 patients from 10 studies worldwide. Underweight patients had lower overall survival (HR=1.69, 95% CI: 1.31-2.19) respect to those having normal weight with consistent results across the HNC sites. Overweight and obese patients had a favourable HNC-specific survival (HR=0.77 (95% CI: 0.70-0.84) and HR=0.80 (95% CI: 0.76-0.84), respectively), with heterogenous results according to HNC site. Our findings show that high BMI values at cancer diagnosis improved the survival rates in patients with HNC, especially among smokers. This association may be explained by residual confounding, reverse causation, and collider stratification bias, but may also suggest that a nutritional reserve may help patients survive HNC cancer.
Original languageEnglish
Pages (from-to)5411-5426
Number of pages16
JournalAmerican Journal of Cancer Research
Volume14
Issue number11
Early online date15 Nov 2024
DOIs
Publication statusPublished - 30 Nov 2024

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