Association of pretreatment body mass index and survival in human papillomavirus positive oropharyngeal squamous cell carcinoma

•82% of HPV+ OPSCC patients have a body mass index greater than 25 kg/m2.•Body mass index > 25 kg/m2 is independently associated with improved overall survival.•Body mass index > 25 kg/m2 is associated with improved disease specific survival.

BackgroundPretreatment body mass index (BMI) >25 kg/m2 is a positive prognostic factor in patients with head and neck cancer. Previous studies have not been adequately stratified by human papilloma virus (HPV) status or subsite. Our objective is to determine prognostic significance of pretreatment BMI on overall survival in HPV+ oropharyngeal squamous cell carcinoma (OPSCC).MethodsThis is a retrospective review of patients with HPV+ OPSCC treated between 8/1/2006 and 8/31/2014. Patients were stratified by BMI status (>/<25 kg/m2). Univariate and multivariate analyses of survival were performed.Results300 patients met our inclusion/exclusion criteria. Patients with a BMI >25 kg/m2 had a longer overall survival (HR = 0.49, P = 0.01) as well as a longer disease-specific survival (HR = 0.43, P = 0.02). Overall survival remained significantly associated with high BMI on multivariate analysis (HR = 0.54, P = 0.04).ConclusionsPre-treatment normal or underweight BMI status is associated with worse overall survival in HPV+ OPSCC.