| Objective: To investigate body mass index(BMI)as aprognostic factor and to examine the relationship between pretherapy BMI and oral squamous cell carcinoma(OSCC)outcomes.Methods: A total of 154 patients diagnosed as OSCC without wight loss from May2009 to June 2014 was included in this retrospective study.Body mass index(BMI)was calculated from measured height and weight and categorized as under-weight(<18.5kg/m2)、normal weight(18.5-23.9kg /m2)、overweight(24.0-27.9kg /m2)、obese(≥28kg/m2).The patients’ age,sex,tumor site,T stage,smoking and drinking history,comorbidity,clinical features,pathological grade,neck dissection surgery rate metastatic lymph noderate postoperative,complications and radiation stomatitis were compared and analyzed.And the univariate and multivariate analysis were used to compare the disease specific survival(DSS)and disease free survival(DFS)between groups.Results: 1.The basic characteristic:154 patients(96 men,58 women)of median age 61 years(range,23-84 years)were included.We found there are 13 patients belong to under-weight group,83 patients in normol group,46 patients in overweight group,12 patients in obesity group.Median BMI respectively is 17.58kg/m2,21.23kg/m2,25.69kg/m2 and 30.65kg/m2.Baseline characteristics were similar by BMI group.The proportion of patients with dibetes and hypertension in the overweight and obesity group was higher than in other group,and the differences were statistically significant(p=0.039).And the postoperative complications(p=0.030)and radiation stomatitis(p=0.006)occurred more frequently in underweight patients than in other group patients.2.In survival analysis,comparing with normal-weight group,the Log‐rank Test indicated no significant relationship between BMI and disease-free survival(DFS)or disease-specific survival(DSS)(p=0.059,p=0.154,respectively).However,in terms of the relative risk(RR)of DSS and DFS in individual group,the RR of obesity group(RR=4.080、RR=2.858)was higher than one.We can see,the DSS and DFS in obesity groups were worse than which is in normal weight group.The survival prognosis is worse when body weight increase.And the Kaplan–Meier curves indicated DSS in the obesity group was worse than that in the normal weight group,p=0.021.And DFS in the obesity group was worse than that in the normal weight group,p=0.041.3.Univariate survival analysis: DSS in the obesity group was lower than that in the normal weight group(p =0.026,HR:4.080,95%CI:1.183-14.077);DFS in the obesity group was lower than that in the normal weight group(p =0.042,HR:2.858,95%CI:1.037-7.874),and the difference was statistically significant,indicating that obese patients exhibited higher risks of recurrence and metastasis than normal‐weight patients.4.Multivariate survival analysis: The results showed that obesity could bea significant independent risk factor of DSS(p=0.009,HR: 10.225,95%CI: 1.782-56.67)and DFS(p=0.045,HR: 3.237,95%CI: 1.027-10.20).Conclusion:1.Of all the groups,obese patients may contribute to a higher risk of recurrence and death than normal‐weight patients.Moreover,underweight patients had a higher risk of postoperative complications and moderate-severe radiation stomatitis.2.Obesity could be an independent risk prognosis factor for OSCC.3.Pretherapy BMI is an important index of the nourishment state in OSCC,and it could be useful to therapy. |
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