Body Mass Index Predicts Tongue SCC Disease-Specific Survival

Patients who are obese when diagnosed with squamous cell carcinoma of the tongue have poorer disease-specific survival than their normal weight counterparts

medwireNews: Obesity significantly impacts prognosis for patients with early-stage tongue Squamous cell carcinoma (SCC), US researchers have found.

Patients with T1 or T2 disease whose presurgery body mass index (BMI) was above 30 kg/m2 had significantly poorer disease-specific survival (DSS) than those with a normal BMI (18.5–24.9 kg/m2), with a hazard ratio (HR) of 5.0 after adjusting for factors, such as age, race, alcohol and smoking habits, histology and treatment.

And the relationship between obesity and DSS was especially strong in patients who had negative lymph nodes, with a HR of 29.5, whereas the association was lost in those with node-positive disease.

Patients who were overweight (BMI=25.0–29.9 kg/m2) also had a trend towards poorer DSS than those with a normal BMI but this did not reach significance.

“Our findings are clinically relevant given both the rising oral tongue SCC and obesity rates worldwide,” say Andrew Dannenberg, from Weill Cornell Medical College in New York, and co-authors.

The study included 155 patients, aged a median of 57 years, who underwent surgery for T1 or T2 SCC of the oral tongue including neck dissection – 65% of patients were node-negative.

The patients had their height and weight noted before surgery; the majority (61%) had stable weight before their diagnosis but 28% of patients, including patients in all BMI classifications, had reported a median prediagnosis weight loss of 4.5 kg.

Obesity was also associated with poor recurrence-free survival and overall survival, although these associations were not statistically significant. However, among patients who did not lose weight before diagnosis, those who were obese had significantly poorer overall survival than those  with a normal BMI (HR=2.70).

“The prognostic impact of obesity may not have previously been recognized due to prediagnosis weight loss related to comorbid habits and tumor stage,” the team comments in Cancer.

“Further mechanistic studies are needed to elucidate the biological underpinnings of this association.”


Iyengar NM, Kochhar A, Morris PG, et al. Impact of obesity on the survival of patients with early-stage squamous cell carcinoma of the oral tongue. Cancer 2014 Jan 21. doi: 10.1002/cncr.28532. [Epub ahead of print].

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