Background: Previous studies have shown that body mass index (BMI) is linked to survival in cancer patients. Our objective was to analyze whether body composition before treatment can predict outcomes in patients with head-and neck cancer.
Methods: All 881 patients with loco-regional head-and -neck cancer treated with curative-intent RT during 2005 to 2012 were retrospectively studied. Body composition analyses by using pre-RT CT images acquired for RT simulation. We compared subcutaneous adipose tissue (SAT) index and muscle index by measuring cross-sectional area of tissues at level of the third thoracic vertebrae (T3) in both genders. Overall survival (OS), loco-regional control (LRC), and distant metastasis-free survival (DFS) were analyzed by body composition index that divided into two groups based on values higher and lower than the median. The median follow-up was 4.68 years.
Results: SAT index in female patients was significantly higher than that in male (p <0.001). The median SAT index and muscle index for female were 15.25 cm2/m2 (range, 0.93-88.09 cm2/m2) and 34.3 cm2/m2 (range, 14.78-73.05 cm2/m2), and for male were 6.19 cm2/m2 (range, 0.21-40.48 cm2/m2) and 51.74 cm2/m2 (range, 8.03-89.06 cm2/m2). The 5-year and 10-year OS, LRC and DFS were 66.3%, 57.6%, 73.4%, 71.4%, 83%, and 82.1%. Higher pre-treatment SAT index was associated with longer OS (HR = 0.616; P = 0.001) and DFS (HR = 0.649; P = 0.015) and a trend towards longer LRC (HR = 0.772; P = 0.066). Pre-treatment muscle index was also a significant predictor of OS (HR = 0.662; P = 0.006) and LRC (HR = 0.684; P = 0.029).
Conclusion: SAT index and muscle index of T3 level obtained from CT images appear to predict outcomes in patients with curative head-and-neck cancers.
Note: This abstract was not presented at the meeting.
Citation Format: Ngan M. Tsang. Subcutaneous fat predict outcome in head and neck cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4747. doi:10.1158/1538-7445.AM2017-4747