The Impact of Pretreatment Low Body Mass Index on Cause-Specific Mortality in Patients with Squamous Cell Carcinoma of the Oral Cavity
The Impact of Pretreatment Low Body Mass Index on Cause-Specific Mortality in Patients with Squamous Cell Carcinoma of the Oral Cavity
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DOI：
10.1080/01635581.2022.2125989
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发表时间：
2022-10
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通讯作者：
Kyoko Kurioka;S. Rin;M. Otsuru;Tomohumi Naruse;T. Hasegawa;N. Yamakawa;S. Yamada;E. Hirai;Kozo Yamamoto;M. Ueda;T. Kirita;M. Akashi;H. Kurita;Y. Ohiro;M. Okura
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作者：
Kyoko Kurioka;S. Rin;M. Otsuru;Tomohumi Naruse;T. Hasegawa;N. Yamakawa;S. Yamada;E. Hirai;Kozo Yamamoto;M. Ueda;T. Kirita;M. Akashi;H. Kurita;Y. Ohiro;M. Okura
摘要 治疗前体重指数 (BMI) 与口腔鳞状细胞癌 (SCC) 结局之间的关联存在争议。我们的目的是研究 BMI 与口腔癌引起的特定原因死亡率之间的关系，以及与死亡率增加相关的失败模式。我们在这项多中心队列研究中招募了 2,023 名东亚患者。我们使用累积发生率竞争风险法和 Fine-Gray 模型来分析与特定原因死亡率、局部复发、区域转移和远处转移作为首发事件相关的因素。中位随访时间为 62 个月。体重不足患者的5年死因死亡率为25.7%，显着高于体重正常患者的5年死因死亡率（12.7%，P < 0.0001）。多变量模型显示体重不足是特定原因死亡率和区域转移的独立危险因素（P < 0.05）。此外，与体重正常的患者相比，体重过轻的患者因特定原因死亡和区域转移的风险分别增加了 51% 和 55%。局部复发与 BMI 类别无关；然而，远处转移的发生率随着BMI值的增加而降低。总之，诊断时体重过轻应被视为口腔鳞状细胞癌的高危死亡因素。
Abstract The association between the pretreatment body mass index (BMI) and oral squamous cell carcinoma (SCC) outcomes is controversial. We aimed to examine the association between BMI and cause-specific mortality due to cancer of the oral cavity and patterns of failure that correlate with increased mortality. We enrolled 2,023 East Asian patients in this multicenter cohort study. We used the cumulative incidence competing risks method and the Fine–Gray model to analyze factors associated with cause-specific mortality, local recurrence, regional metastasis, and distant metastasis as first events. The median follow-up period was 62 mo. The 5-year cause-specific mortality for patients with underweight was 25.7%, which was significantly higher than that for patients with normal weight (12.7%, P < 0.0001). The multivariate model revealed that underweight was an independent risk factor for cause-specific mortality and regional metastasis (P < 0.05). Moreover, patients with underweight displayed a 51% and 55% increased risk of cause-specific mortality and regional metastasis, respectively, compared with their normal weight counterparts. Local recurrence was not associated with the BMI categories; however, the incidence of distant metastasis inversely decreased with BMI value. In summary, being underweight at diagnosis should be considered a high-risk mortality factor for oral SCC.