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Pretreatment body mass index and serum uric acid and albumin levels as prognostic predictors in patients with oral squamous cell carcinoma
Wei-Chin Chang1, Cheng-Yu Yang2, Yu-Chun Lin3, Chun-Shu Lin4, Chin-Shan Kuo1, Yu-Hsuan Li1, Yuan-Wu Chen1
1 Department of Oral and Maxillofacial Surgery, Tri Service General Hospital; School of Dentistry, National Defense Medical Center, Taipei, Taiwan, Republic of China
2 School of Dentistry, National Defense Medical Center, Taipei, Taiwan, Republic of China
3 School of Dentistry, National Defense Medical Center; Department of Pathology, Tri Service General Hospital, Taipei, Taiwan, Republic of China
4 Department of Radiation Oncology, Tri Service General Hospital, Taipei, Taiwan, Republic of China
Correspondence Address:
Dr. Yuan-Wu Chen
Division of Oral and Maxillofacial Surgery, Tri-Service General Hospital, 2F, No. 325, Sec. 2, Chenggong Road, Neihu District, Taipei City 114
Republic of China
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jmedsci.jmedsci_325_20
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Background: Oral squamous cell carcinoma (OSCC) is the most frequently found malignant tumor of the oral cavity, and the annual death rate of OSCC patients has been increasing rapidly among the Taiwanese population. Aim: The aim of this study is to evaluate if poor nutrition is a potential adverse prognostic factor in patients with OSCC. Methods: This cross-sectional study included 322 patients with OSCC who underwent therapeutic surgical treatment in Taiwan. The pretreatment body mass index (BMI) and serum uric acid and albumin levels were measured as common indicators of the nutritional status, and overall survival (OS) was analyzed using the Kaplan–Meier method and a Cox regression model. Results: The optimal cut-off values were 24.0 kg/m[2], 5.05 mg/dL, and 3.85 g/dL for BMI, serum uric acid, and serum albumin, respectively. The multivariate Cox regression analysis indicated lower BMI (hazard ratio [HR] = 1.557, 95% confidence interval [95% CI]: 1.070–2.265; P = 0.021), lower serum uric acid (HR = 1.857, 95% CI: 1.265–2.724; P = 0.002), and lower serum albumin (HR = 2.011, 95% CI: 1.278–3.163; P = 0.003) as independent and significant prognosticators of OS. Advanced stage, depth of invasion of more than 5 mm, and extranodal extension were prognostic predictors of poor OS. Conclusion: A lower preoperative BMI and lower serum uric acid and albumin levels are predictors of significantly worse survival among OSCC patients. Maintaining a healthy nutritional status is crucial to improving the survival of patients with oral cancer. The treatment for patients with poor nutritional status should be more aggressive and cautious.
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