Low body mass index at 3 months following adjuvant chemoradiation affects survival of postoperative locally advanced oral cavity cancer patients.

OBJECTIVES/HYPOTHESIS: To investigate the association between body mass index and outcomes such as recurrence and survival in postoperative locally advanced oral cavity cancer patients who underwent adjuvant chemoradiation. STUDY DESIGN: Retrospective analysis of patient data and outcomes. METHODS: We retrospectively analyzed the records of 61 stage III, IVA, and IVB oral cavity cancer patients who were treated with curative surgery and adjuvant chemoradiation between 2007 and 2009. Each patient's body mass index was recorded throughout the treatment duration and after its completion. The associations between demographic variables, body mass index, and survival outcomes were determined by univariate and multivariate analyses. RESULTS: Overall, body mass index decreased throughout the chemoradiation period and reached the nadir at 3 months after completion of therapy. Univariate analysis showed that patients with body mass index <18.5 kg/m(2) at 3 months after chemoradiation had significantly higher recurrence and decreased survival rates. Multivariate analysis confirmed that body mass index <18.5 kg/m(2) at this time point is an independent predictor for recurrence (P = .039) and overall survival (P = .043). CONCLUSIONS: Early recurrence can be predicted by malnourished status 3 months after treatment completion. Malnourishment has significant negative effects on overall survival in locally advanced postoperative oral cavity cancer patients who are undergoing adjuvant chemoradiation. After therapy is completed, nutritional guidance and care should be continued for patients with this advanced disease.