A RECENT study analysing patients with head and neck squamous cell carcinoma (HNSCC) who received immune checkpoint inhibitors revealed that those with obesity had significantly better survival outcomes compared to patients with a normal body mass index (BMI). The retrospective population-based cohort study also showed that obese patients experienced decreased reliance on gastrostomy and tracheostomy tubes.
The study utilised the TriNetX Global Collaborative Network database to identify 166 patients treated between 2012 and 2023, evenly split between those with normal BMI (20-24.9 kg/m²) and those with obesity (BMI ≥30 kg/m²). The researchers evaluated overall survival (OS) and functional outcomes such as dysphagia, tracheostomy dependence, and gastrostomy tube dependence over a five-year period.
Results indicated that patients with obesity had improved OS at 6 months, 3 years, and 5 years, with hazard ratios of 0.54, 0.56, and 0.62, respectively. Moreover, these patients exhibited reduced gastrostomy tube dependence at all evaluated time points and diminished tracheostomy dependence after one year.
While the findings suggest a potential survival advantage for obese patients, lead author Dr. Eric V. Mastrolonardo and colleagues emphasized the need for further research to understand the underlying mechanisms. The study acknowledged limitations, including the inability to account for BMI changes during treatment and to track progression-free survival (PFS) using the TriNetX platform.
Helena Bradbury, EMJ
Reference
Macias D et al. Association Between Observer-Rated Disfigurement and Body Image–Related Distress Among Head and Neck Cancer Survivors. JAMA Otolaryngol Head Neck Surg. 2022;148(7):688-689.
