Association between pretreatment obesity, sarcopenia, and survival in patients with head and neck cancer

Michael Fattouh, Gina Y. Chang, Thomas J. Ow, Keivan Shifteh, Gregory Rosenblatt, Viraj M. Patel, Richard V. Smith, Michael B. Prystowsky, Nicolas F. Schlecht

Research output: Contribution to journalArticlepeer-review

50 Scopus citations


Background: Body mass index (BMI), sarcopenia, and obesity-related comorbidities have been associated with head and neck squamous cell carcinoma (HNSCC) progression. Methods: We conducted a retrospective analysis of 441 normal-weight, overweight, and obese HNSCC patients treated at Montefiore Medical Center (New York). Patients were grouped by BMI prior to treatment and assessed for differences in survival adjusting for comorbid conditions (cardiovascular disease and diabetes). Evidence of sarcopenia was also assessed using pretreatment abdominal CT scans in a subset of 113 patients. Results: Prior to treatment, 55% of HNSCC patients were overweight or obese. Overweight/obese patients had significantly better overall survival (hazard ratio [HR] = 0.4, 95% CI: 0.3-0.6) compared to normal-weight patients, independent of comorbid conditions. Patients with sarcopenia had significantly poorer survival (HR = 2.1, 95% CI: 1.1-3.9) compared to non-sarcopenic patients, with the strongest association seen among overweight/obese patients. Conclusion: Our data support the importance of sarcopenia assessment, in addition to BMI, among patients with HNSCC.

Original languageEnglish (US)
Pages (from-to)707-714
Number of pages8
JournalHead and Neck
Issue number3
StatePublished - Mar 1 2019


  • body mass index
  • epidemiology
  • obesity
  • sarcopenia
  • survival

ASJC Scopus subject areas

  • Otorhinolaryngology


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