Influence of Body Mass Index on Survival and Prognosis in Squamous Cell Carcinoma of Head and Neck

OBJECTIVE: Differences in body mass index (BMI) were used to analyze the survival and prognosis of SCCHN patients. PATIENTS AND METHODS: A retrospective cohort study was conducted to select 323 patients who underwent surgical treatment for SCCHN from June 2013 to June 2016. The patients were divided into a healthy BMI group (BMI<24kg/m(2)), an overweight group (24kg/m(2)≤BMI<28kg/m(2)) and an obese group (BMI≥28 kg/m(2)). Various statistical methods were used to summarize and analyze clinical data, complications, disease specific survival (DSS), the overall survival (OS), and recurrence-free survival (RFS) within the last 3 y. RESULTS: At 3 y, OS (54.40%) and DSS (51.94%) were slightly lower in the obese group compared with the overweight (64.62%, 61.92%) and healthy BMI groups (64.66%, 65.02%), but no statistical significance was found in DSS (P=0.178), OS (P=0.123) and RFS (P=0.362). The difference in operation duration (P=0.008) and bleeding volume (P=0.001) in obese patients was consistent with those in diabetes mellitus (P=0.002) and coronary heart disease (P=0.000). A high incidence of pharyngeal fistula was observed in obese (P=0.014) and overweight patients (P=0.025), but mouth floor fistula (P=0.038), lung infection (P=0.047), fat liquefaction (P=0.003) and lower extremities deep venous thrombosis (P=0.020) were only found in the obese group. Cox univariatable and multivariatable analysis showed that clinical stage, T stage, and N stage were independent prognostic factors for patients with SCCHN, which was not related to BMI. CONCLUSION: BMI was associated with a higher probability of complications. However, BMI had no significant correlation with 3-year OS, RFS and DSS, and was not a prognostic indicator for patients with SCCHN.