Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Nutr Cancer. 2013;65(3):417-23. doi: 10.1080/01635581.2013.767365.
Significant loss of body weight (SLW) by patients treated for squamous cell carcinomas of the oral cavity and oropharynx (OSCC) may affect treatment completion and results. We assessed factors predicting SLW and its correlation with disease-free survival (DFS) in these patients. We evaluated 226 consecutive patients with previously untreated, operable OSCC whose body weight was recorded before, during, and for up to 1 year after treatment. SLW was defined as ≥10% reduction in pretreatment body weight. Clinicopathologic parameters were compared in patients with and without SLW. Of the 226 patients, 94 (41.6%) experienced SLW and 132 (58.4%) did not. Univariate analyses showed that factors significantly associated with SLW included T3-4, N+, stage III-IV, and oropharyngeal tumors, nonsurgical (radiotherapy or chemotherapy) vs. surgical treatment, posttreatment recurrence, histologic differentiation, involved resection margin, and number of metastatic lymph nodes (pLNs) ≥ 3 (P < 0.05). Multivariate analyses showed that radiotherapy, recurrence, and number of pLNs were significant independent predictors of SLW (P < 0.005). DFS rate was significantly higher in patients without than with SLW (P < 0.01). OSCC patients with multiple pLNs, those undergoing radiotherapy, and those with posttreatment recurrences may require close nutritional monitoring and support.
口腔和口咽鳞状细胞癌（OSCC）患者经治疗后出现明显的体重下降（SLW）可能会影响治疗的完成和结果。我们评估了预测 SLW 的因素及其与这些患者无病生存率（DFS）的相关性。我们评估了 226 例先前未经治疗、可手术治疗的 OSCC 连续患者，在治疗前、治疗期间和治疗后长达 1 年内记录了他们的体重。SLW 定义为治疗前体重下降≥10%。比较了有和无 SLW 的患者的临床病理参数。在 226 例患者中，94 例（41.6%）出现 SLW，132 例（58.4%）未出现 SLW。单因素分析显示，与 SLW 显著相关的因素包括 T3-4、N+、III-IV 期和口咽肿瘤、非手术（放疗或化疗）与手术治疗、治疗后复发、组织学分化、累及切缘和阳性淋巴结（pLNs）数≥3（P<0.05）。多因素分析显示，放疗、复发和 pLNs 数是 SLW 的显著独立预测因素（P<0.005）。无 SLW 的患者的 DFS 率明显高于有 SLW 的患者（P<0.01）。有多个 pLNs、接受放疗和治疗后复发的 OSCC 患者可能需要密切的营养监测和支持。
