Post-treatment weight change in oral cavity and oropharyngeal squamous cell carcinoma

Zi Zhang, Justin C. Brown, Bert W. O’Malley, Andrea B. Troxel, Joshua M. Bauml, Kaitlyn R. Rubnitz, Colleen M. Grosso, Gregory S. Weinstein, Kathryn H. Schmitz

Research output: Contribution to journalArticle

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Abstract

Purpose: Incidence of head and neck cancer (HNC) due to human papillomavirus (HPV) infection has been increasing. Treatment regimens have evolved. These changes might result in alterations of assumed treatment-related weight changes for HNC patients. We aimed to compare the trajectory of pre- to post-treatment weight changes of oropharyngeal squamous cell carcinoma (OPSCC) versus oral cavity squamous cell carcinoma (OCSCC) patients and to compare weight changes between patients with primary surgery ± adjuvant therapy to patients with primary radiation and/or chemotherapy. Methods: This retrospective cohort study examined adult OPSCC and OCSCC patients with initial definitive treatment at the University of Pennsylvania from January 1, 2009 to December 31, 2010. Patient demographics, medical history, treatments, and pre- and post-treatment body weight data were collected from electronic medical records. Mixed-effects modeling was performed. Results: Among 354 patients who met the inclusion criteria, 290 (82 %) survivors were available for inclusion by 24-month follow-up. More than 70 % OPSCC and OCSCC patients were overweight or obese at all pre- and post-treatment time points. The average weight among OPSCC patients was 6.63 kg higher than OCSCC patients at all time points (mean = 6.63, 95 % confidence interval (CI), 2.46–10.79, p = 0.002). After adjusting for potential confounders, patients with primary surgery had significantly more weight gain from pre-treatment to 12–18 month post-treatment follow-up as compared to patients with primary radiation and/or chemotherapy (adjusted mean = 4.01, 95 % CI, 0.16–7.87, p = 0.041). Conclusion: Overweight and obesity may be a new challenge in OPSCC and OCSCC patient care. Further study is needed to evaluate whether exercise and nutritional interventions can improve their survivorship.

Original languageEnglish (US)
Pages (from-to)2333-2340
Number of pages8
JournalSupportive Care in Cancer
Volume24
Issue number5
DOIs
StatePublished - May 1 2016

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Mouth
Squamous Cell Carcinoma
Weights and Measures
Therapeutics
Head and Neck Neoplasms
Confidence Intervals
Radiation
Drug Therapy
Papillomavirus Infections
Electronic Health Records
Weight Gain
Survivors
Patient Care
Cohort Studies
Survival Rate
Retrospective Studies
Obesity
Body Weight
Demography
Exercise

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Zhang, Z., Brown, J. C., O’Malley, B. W., Troxel, A. B., Bauml, J. M., Rubnitz, K. R., ... Schmitz, K. H. (2016). Post-treatment weight change in oral cavity and oropharyngeal squamous cell carcinoma. Supportive Care in Cancer, 24(5), 2333-2340. https://doi.org/10.1007/s00520-015-3029-6
Zhang, Zi ; Brown, Justin C. ; O’Malley, Bert W. ; Troxel, Andrea B. ; Bauml, Joshua M. ; Rubnitz, Kaitlyn R. ; Grosso, Colleen M. ; Weinstein, Gregory S. ; Schmitz, Kathryn H. / Post-treatment weight change in oral cavity and oropharyngeal squamous cell carcinoma. In: Supportive Care in Cancer. 2016 ; Vol. 24, No. 5. pp. 2333-2340.
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abstract = "Purpose: Incidence of head and neck cancer (HNC) due to human papillomavirus (HPV) infection has been increasing. Treatment regimens have evolved. These changes might result in alterations of assumed treatment-related weight changes for HNC patients. We aimed to compare the trajectory of pre- to post-treatment weight changes of oropharyngeal squamous cell carcinoma (OPSCC) versus oral cavity squamous cell carcinoma (OCSCC) patients and to compare weight changes between patients with primary surgery ± adjuvant therapy to patients with primary radiation and/or chemotherapy. Methods: This retrospective cohort study examined adult OPSCC and OCSCC patients with initial definitive treatment at the University of Pennsylvania from January 1, 2009 to December 31, 2010. Patient demographics, medical history, treatments, and pre- and post-treatment body weight data were collected from electronic medical records. Mixed-effects modeling was performed. Results: Among 354 patients who met the inclusion criteria, 290 (82 {\%}) survivors were available for inclusion by 24-month follow-up. More than 70 {\%} OPSCC and OCSCC patients were overweight or obese at all pre- and post-treatment time points. The average weight among OPSCC patients was 6.63 kg higher than OCSCC patients at all time points (mean = 6.63, 95 {\%} confidence interval (CI), 2.46–10.79, p = 0.002). After adjusting for potential confounders, patients with primary surgery had significantly more weight gain from pre-treatment to 12–18 month post-treatment follow-up as compared to patients with primary radiation and/or chemotherapy (adjusted mean = 4.01, 95 {\%} CI, 0.16–7.87, p = 0.041). Conclusion: Overweight and obesity may be a new challenge in OPSCC and OCSCC patient care. Further study is needed to evaluate whether exercise and nutritional interventions can improve their survivorship.",
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Zhang, Z, Brown, JC, O’Malley, BW, Troxel, AB, Bauml, JM, Rubnitz, KR, Grosso, CM, Weinstein, GS & Schmitz, KH 2016, 'Post-treatment weight change in oral cavity and oropharyngeal squamous cell carcinoma', Supportive Care in Cancer, vol. 24, no. 5, pp. 2333-2340. https://doi.org/10.1007/s00520-015-3029-6

Post-treatment weight change in oral cavity and oropharyngeal squamous cell carcinoma. / Zhang, Zi; Brown, Justin C.; O’Malley, Bert W.; Troxel, Andrea B.; Bauml, Joshua M.; Rubnitz, Kaitlyn R.; Grosso, Colleen M.; Weinstein, Gregory S.; Schmitz, Kathryn H.

In: Supportive Care in Cancer, Vol. 24, No. 5, 01.05.2016, p. 2333-2340.

Research output: Contribution to journalArticle

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T1 - Post-treatment weight change in oral cavity and oropharyngeal squamous cell carcinoma

AU - Zhang, Zi

AU - Brown, Justin C.

AU - O’Malley, Bert W.

AU - Troxel, Andrea B.

AU - Bauml, Joshua M.

AU - Rubnitz, Kaitlyn R.

AU - Grosso, Colleen M.

AU - Weinstein, Gregory S.

AU - Schmitz, Kathryn H.

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Purpose: Incidence of head and neck cancer (HNC) due to human papillomavirus (HPV) infection has been increasing. Treatment regimens have evolved. These changes might result in alterations of assumed treatment-related weight changes for HNC patients. We aimed to compare the trajectory of pre- to post-treatment weight changes of oropharyngeal squamous cell carcinoma (OPSCC) versus oral cavity squamous cell carcinoma (OCSCC) patients and to compare weight changes between patients with primary surgery ± adjuvant therapy to patients with primary radiation and/or chemotherapy. Methods: This retrospective cohort study examined adult OPSCC and OCSCC patients with initial definitive treatment at the University of Pennsylvania from January 1, 2009 to December 31, 2010. Patient demographics, medical history, treatments, and pre- and post-treatment body weight data were collected from electronic medical records. Mixed-effects modeling was performed. Results: Among 354 patients who met the inclusion criteria, 290 (82 %) survivors were available for inclusion by 24-month follow-up. More than 70 % OPSCC and OCSCC patients were overweight or obese at all pre- and post-treatment time points. The average weight among OPSCC patients was 6.63 kg higher than OCSCC patients at all time points (mean = 6.63, 95 % confidence interval (CI), 2.46–10.79, p = 0.002). After adjusting for potential confounders, patients with primary surgery had significantly more weight gain from pre-treatment to 12–18 month post-treatment follow-up as compared to patients with primary radiation and/or chemotherapy (adjusted mean = 4.01, 95 % CI, 0.16–7.87, p = 0.041). Conclusion: Overweight and obesity may be a new challenge in OPSCC and OCSCC patient care. Further study is needed to evaluate whether exercise and nutritional interventions can improve their survivorship.

AB - Purpose: Incidence of head and neck cancer (HNC) due to human papillomavirus (HPV) infection has been increasing. Treatment regimens have evolved. These changes might result in alterations of assumed treatment-related weight changes for HNC patients. We aimed to compare the trajectory of pre- to post-treatment weight changes of oropharyngeal squamous cell carcinoma (OPSCC) versus oral cavity squamous cell carcinoma (OCSCC) patients and to compare weight changes between patients with primary surgery ± adjuvant therapy to patients with primary radiation and/or chemotherapy. Methods: This retrospective cohort study examined adult OPSCC and OCSCC patients with initial definitive treatment at the University of Pennsylvania from January 1, 2009 to December 31, 2010. Patient demographics, medical history, treatments, and pre- and post-treatment body weight data were collected from electronic medical records. Mixed-effects modeling was performed. Results: Among 354 patients who met the inclusion criteria, 290 (82 %) survivors were available for inclusion by 24-month follow-up. More than 70 % OPSCC and OCSCC patients were overweight or obese at all pre- and post-treatment time points. The average weight among OPSCC patients was 6.63 kg higher than OCSCC patients at all time points (mean = 6.63, 95 % confidence interval (CI), 2.46–10.79, p = 0.002). After adjusting for potential confounders, patients with primary surgery had significantly more weight gain from pre-treatment to 12–18 month post-treatment follow-up as compared to patients with primary radiation and/or chemotherapy (adjusted mean = 4.01, 95 % CI, 0.16–7.87, p = 0.041). Conclusion: Overweight and obesity may be a new challenge in OPSCC and OCSCC patient care. Further study is needed to evaluate whether exercise and nutritional interventions can improve their survivorship.

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Zhang Z, Brown JC, O’Malley BW, Troxel AB, Bauml JM, Rubnitz KR et al. Post-treatment weight change in oral cavity and oropharyngeal squamous cell carcinoma. Supportive Care in Cancer. 2016 May 1;24(5):2333-2340. https://doi.org/10.1007/s00520-015-3029-6