Long-term Change of Body Mass Index after Head and Neck Cancer Treatment

Abstract

Objectives:

Although head and neck cancer (HNC) is associated with weight loss, little is known about the long-term body mass index (BMI) change in HNC survivors. Our goal was to determine the long-term BMI change after HNC treatment.

Methods:

Retrospective cohort study on patients with oral cavity and pharyngeal squamous cell carcinoma who received initial treatment at the University of Pennsylvania Health System in 2009, and were then followed for 3 years. Patient demographics, height, tobacco and alcohol use, cancer type, AJCC stage, treatments, and weight at all visits were collected from medical records. Underweight was defined as BMI<18.5, normal was BMI 18.5-24.9, overweight was BMI 25.0-29.9, and obesity was BMI > 30. Logistic regression was performed to identify factors associated with long-term BMI changes.

Results:

We identified 211 patients with complete data and follow-up visits. At the time of diagnosis, 7% patients were underweight (n = 15), 34% had normal-weight (n = 72), 36% were overweight (n = 75) and 23% were obese (n = 49). At the last follow-up visit, 7% were underweight (n = 14), 42% were normal-weight (n = 82), 33% were overweight (n = 65) and 18% were obese (n = 36). Thus, 17% patients (n = 21) who were overweight or obese at diagnosis improved to normal weight at the end of 3-year follow-up, and this change was not significantly affected by patients’ age, gender, race, tobacco and alcohol use, cancer site, AJCC stage, and treatment type.

Conclusions:

Our study suggests BMI improves in overweight or obese HNC survivors after 3-year follow-up, and this change is independent of cancer severity and treatment type.