体重指数与头颈癌患者的预后

Body mass index and prognosis in patients with head and neck cancer.

作者信息

Gama Ricardo Ribeiro, Song Yuyao, Zhang Qihuang, Brown M Catherine, Wang Jennifer, Habbous Steven, Tong Li, Huang Shao Hui, O'Sullivan Brian, Waldron John, Xu Wei, Goldstein David, Liu Geoffrey

机构信息

Head and Neck Surgery Department, Barretos Cancer Hospital, Barretos, Brazil.

Biostatistics Department, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.

出版信息

Head Neck. 2017 Jun;39(6):1226-1233. doi: 10.1002/hed.24760. Epub 2017 Mar 21.

DOI:10.1002/hed.24760

PMID:28323362

Abstract

BACKGROUND

Body mass index (BMI) has been associated variably with head and neck cancer outcomes. We evaluated the association between BMI at either diagnosis or at early adulthood head and neck cancer outcomes.

METHODS

Patients with invasive head and neck squamous cell cancer at Princess Margaret Cancer Centre in Toronto, Canada, were surveyed on tobacco and alcohol exposure, performance status, comorbidities, and BMI at diagnosis. A subset also had data collected for BMI at early adulthood.

RESULTS

With a median follow-up of 2.5 years, in 1279 analyzed patients, being overweight (hazard ratio [HR], 0.55; 95% confidence interval [CI], 0.4-0.8; p = .001) at diagnosis was associated with improved survival when compared with individuals with normal weight. In contrast, underweight patients at diagnosis were associated with a worse outcome (HR, 1.89; 95% CI, 1.2-3.1; p < .01).

CONCLUSION

Being underweight at diagnosis was an independent, adverse prognostic factor, whereas being overweight conferred better prognosis. BMI in early adulthood was not associated strongly with head and neck cancer outcomes. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1226-1233, 2017.

摘要

背景

体重指数（BMI）与头颈癌的预后存在不同程度的关联。我们评估了诊断时或成年早期的BMI与头颈癌预后之间的关联。

方法

对加拿大多伦多玛格丽特公主癌症中心的浸润性头颈鳞状细胞癌患者进行了调查，内容包括烟草和酒精暴露情况、身体状况、合并症以及诊断时的BMI。其中一部分患者还收集了成年早期的BMI数据。

结果

在1279例接受分析的患者中，中位随访时间为2.5年，与体重正常的个体相比，诊断时超重（风险比[HR]，0.55；95%置信区间[CI]，0.4 - 0.8；p = 0.001）与生存率提高相关。相反，诊断时体重过轻的患者预后较差（HR，1.89；95% CI，1.2 - 3.1；p < 0.01）。