Obese individuals who are diagnosed with early-stage squamous cell carcinoma (SCC) of the tongue have a five-fold greater risk of dying from the disease, according to a recent retrospective study.1
Researchers at Memorial Sloan-Kettering Cancer Center (MSKCC) analyzed data from 155 patients with stage T1 or T2 SCC of the tongue who underwent resection with curative intent during a 10-year period. The primary study outcome was disease-specific survival (DSS), defined as the time from surgery to death from SCC of the tongue.
At the time of surgery, 63 patients (41%) were normal weight (body mass index [BMI], 18.5 to 24.9 kg/m2), 62 patients (40%) were overweight (BMI, 25 to 29.9 kg/m2), and 30 patients (19%) were obese (BMI >30 kg/m2). Mean patient age was 57 years, 58% were male, 70% had T1 tumors, and 65% had lymph node-negative disease.
Older patients and those with diabetes were more likely to be obese. About 25% of patients reported weight loss immediately before diagnosis.
As Weight Increases, Survival Declines
At the last follow-up, 87 patients (56%) had no evidence of SCC of the tongue, 13 (8%) were alive with the disease, 32 (21%) had died of the disease, 11 (7%) had died of other causes, and 12 (8%) had died of unknown causes.
After 3 years, the DSS rates were 68% (95% CI: 52%-89%) for obese patients, 81% (95% CI: 71%-92%) for overweight patients, and 87% (95% CI: 78%-96%) for normal-weight patients.
Multivariable analysis adjusting for known risk factors for mortality after SCC of the tongue (including age, T stage, tumor thickness and grade, and metastasis) showed that obese patients were five times more likely to die of the disease than normal-weight patients (hazard ratio, 5.01; 95% CI: 1.69-14.81; P=0.004).