Longitudinal Baseline Weight Recovery and Survival in Head and Neck Cancer

Saturday, September 28, 2024

10:24 AM – 10:30 AM EDT

Location: MBCC, 208

Disclosure(s):

Amanda Joy Bastien, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Luv A. Amin:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jon Mallen-St. Clair, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Allen S. Ho:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: As a surrogate of malnutrition, degree of weight loss from head and neck cancer treatment is often underestimated. Moreover, the likelihood of weight recovery and its impact are similarly overlooked. We characterize critical weight loss and longitudinal return to baseline weight and its effect on outcomes.

Methods: Retrospective cohort study from 2014-2022 assessing newly diagnosed 265 adult head and neck cancer patients who completed radiation (definitive or adjuvant) for curative intent. Weight was measured at defined timepoints during/after radiation until recurrence or death. Relevant patient, tumor, treatment, and nutritional factors were analyzed using multivariable logistic regression models.

Results: Altogether, 265 patients were evaluated with a mean follow-up of 38.4 months (SD ± 21.8). Oropharyngeal cancers comprised the majority of cases (50.9%), followed by oral cavity (12.7%). A percentage of 36.3% patients underwent surgery, while 71.5% patients had chemotherapy. Patients reached a nadir at mean 4.2 mo (SD ± 2.1) after radiation, with a mean weight loss of 7.8% (SD ± 11.3). Notably, 47.6% of patients had 10% critical weight loss (CWL), and 48.2% returned to baseline weight (RBW). For those patients who recovered RBW, mean time to RBW was 17.4 months (SD ± 18.7). On MVA, RBW by 12 mo was significantly associated with overall survival (HR 0.25, 95% CI 0.08-0.73, p = 0.011). Factors associated with RBW failure included CWL (OR 2.03, 95% CI 1.30-3.18, p = 0.002) and SLP consultation (OR 0.32, 95% CI 0.19-0.53, p < 0.001).

Conclusions: An unexpectedly high incidence of HNC patients fail to recover their baseline weight after treatment, and take longer than predicted to achieve recovery. Even in ideal settings with compliant patients, RBW failure is associated with a marked decrease in overall survival. Avoiding critical weight loss and ensuring SLP consultation are determinants independently associated with addressing this modifiable risk factor. Measures to promote RBW may reduce mortality.

Presenting Author(s)

AB

Amanda Joy Bastien, MD

Resident Physician
Cedars Sinai
Los Angeles, California, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Luv A. Amin

Medical Student
California University of Science and Medicine, School of Medicine
San Clemente, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Jon Mallen-St. Clair, MD, PhD

Assistant Professor
Cedars Sinai
Los Angeles, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
MV

Missael Vasquez

Cedars Sinai, United States

Disclosure information not submitted.
ZZ

Zachary Zumsteg, MD

Cedars Sinai, United States

Disclosure information not submitted.

Senior Author(s)

Allen S. Ho

Professor of Surgery
Cedars-Sinai Medical Center
Los Angeles, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.