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Post-treatment weight change in oral cavity and oropharyngeal squamous cell carcinoma

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Abstract

Purpose

Incidence of head and neck cancer (HNC) due to human papillomavirus (HPV) infection has been increasing. Treatment regimens have evolved. These changes might result in alterations of assumed treatment-related weight changes for HNC patients. We aimed to compare the trajectory of pre- to post-treatment weight changes of oropharyngeal squamous cell carcinoma (OPSCC) versus oral cavity squamous cell carcinoma (OCSCC) patients and to compare weight changes between patients with primary surgery ± adjuvant therapy to patients with primary radiation and/or chemotherapy.

Methods

This retrospective cohort study examined adult OPSCC and OCSCC patients with initial definitive treatment at the University of Pennsylvania from January 1, 2009 to December 31, 2010. Patient demographics, medical history, treatments, and pre- and post-treatment body weight data were collected from electronic medical records. Mixed-effects modeling was performed.

Results

Among 354 patients who met the inclusion criteria, 290 (82 %) survivors were available for inclusion by 24-month follow-up. More than 70 % OPSCC and OCSCC patients were overweight or obese at all pre- and post-treatment time points. The average weight among OPSCC patients was 6.63 kg higher than OCSCC patients at all time points (mean = 6.63, 95 % confidence interval (CI), 2.46–10.79, p = 0.002). After adjusting for potential confounders, patients with primary surgery had significantly more weight gain from pre-treatment to 12–18 month post-treatment follow-up as compared to patients with primary radiation and/or chemotherapy (adjusted mean = 4.01, 95 % CI, 0.16–7.87, p = 0.041).

Conclusion

Overweight and obesity may be a new challenge in OPSCC and OCSCC patient care. Further study is needed to evaluate whether exercise and nutritional interventions can improve their survivorship.

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Authors and Affiliations

  1. Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, 8th Floor, Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA

    Zi Zhang, Justin C. Brown, Andrea B. Troxel, Kaitlyn R. Rubnitz & Kathryn H. Schmitz

  2. Department of Otorhinolaryngology—Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Bert W. O’Malley Jr. & Gregory S. Weinstein

  3. Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Joshua M. Bauml

  4. Cancer Registry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Colleen M. Grosso

Authors
  1. Zi Zhang
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  2. Justin C. Brown
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  3. Bert W. O’Malley Jr.
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  4. Andrea B. Troxel
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  5. Joshua M. Bauml
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  6. Kaitlyn R. Rubnitz
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  7. Colleen M. Grosso
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  8. Gregory S. Weinstein
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  9. Kathryn H. Schmitz
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Corresponding author

Correspondence to Kathryn H. Schmitz.

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Conflict of interest

The research for this manuscript was supported in part by the National Institutes of Health (U54-CA155850) awarded to K.H.S., and J.C.B. and Z.Z. were funded under the U54-CA155850. The opinions and conclusions of the authors are not necessarily those of the sponsoring agency. B.W.O. and G.S.W. receive royalties from Olympus Corporation through the University of Pennsylvania. All the other authors did not report any conflicts of interest. The first author and corresponding authors have full control of all primary data and agree to allow the journal to review the data if requested.

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Zhang, Z., Brown, J.C., O’Malley, B.W. et al. Post-treatment weight change in oral cavity and oropharyngeal squamous cell carcinoma. Support Care Cancer 24, 2333–2340 (2016). https://doi.org/10.1007/s00520-015-3029-6

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  • DOI: https://doi.org/10.1007/s00520-015-3029-6

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