Determination of Factors Associated with Critical Weight Loss in Oral Cavity Carcinoma Patients: A Retrospective Cohort Study

Abstract

Introduction Critical weight loss is defined as an unintentional weight loss of ≥ 5% at 1 month or ≥ 10% at 6 months from the start of treatment. Critical weight loss leads to deterioration of the immune function and reduced tolerance to treatment (surgery ± radiochemotherapy) as well as increased complication rates. Objective Critical weight loss, defined as a weight loss of ≥ 5% after 1 month or ≥ 10% after 6 months from the start of treatment, is not uncommon in head and neck cancer patients. We aimed to assess the factors associated with critical weight loss during the treatment of oral cavity squamous cell carcinoma patients. Methods A retrospective cohort study was performed at the Aga Khan University Hospital, in Karachi, Pakistan, on 125 patients. Patients receiving adjuvant therapy were considered exposed, and the outcome was critical weight loss. Results The mean age of presentation was 46.9 ± 12.8 years in patients undergoing surgery and adjuvant therapy, with 119 (79.3%) of them being male and 31 (20.7%) female. One hundred and twelve patients (81.3%) developed critical weight loss at 6 months from the start of treatment, and the only significant variable associated with critical weight loss was the stage of the disease ( p = 0.03). Conclusion A large proportion of patients with oral cancer developed critical weight loss requiring a need for intervention. The overall stage of the disease is a significant predictor of critical weight loss in patients undergoing treatment.

Predictive Factors for Critical Weight Loss in Saudi Head and Neck Cancer Patients Undergoing (Chemo)Radiotherapy

“…Patient TNM staging (T refers to the primary tumor, N refers to whether lymphatic nodes are affected, and M refers to further metastases) (National Cancer Institute; NIH, 2015) was classified into four groups according to cancer stage: I, II, III, and IV. Cancer stages were classified further into two groups: early (stages I and II) and advanced (stages III and IV) [10]. The sample distribution according to the inclusion and exclusion criteria is described in Figure 1.…”

Fatores associados à indicação de via alternativa de alimentação após câncer de língua

“…A segunda pesquisa 13 inclusa, apresentava como objetivo avaliar os fatores associados à perda crítica de peso durante o tratamento de pacientes com carcinoma epidermóide de cavidade oral. Os indivíduos inclusos nos estudos foram (n=150) pacientes maiores de 18 anos com diagnóstico confirmado de carcinoma espinocelular de cavidade oral.…”

“…A média de idade dos pacientes submetidos à cirurgia com terapia adjuvante foi de 46,9 ± 12,77 anos. A maioria dos pacientes era do sexo masculino 89 (80,2%), e os demais 22 (19,8%), do sexo feminino 13 .…”

“…Idade, sexo e estágio da doença foram fatores variáveis do terapia adjuvante e comorbidades. Foi observado que os pacientes com a doença em estágio avançado (estágio III e IV) são mais propensos a desenvolver perda de peso e, consequentemente, receber a nutrição enteral, visto que esses pacientes são mais submetidos à ressecção extensa associada à terapia adjuvante 13 . Dentre os (n=150) pacientes inclusos no estudo, 29 (19,3%) tiveram o modo de nutrição por tubo de alimentação.…”

“…Nos pacientes submetidos apenas à cirurgia, 2 (5,1%) necessitaram de sonda NG, 20 (51,2%) gastrostomia e 5 (12,8%) PEG. No grupo submetido a cirurgia e terapia adjuvante, 5 (4,5%) necessitaram de sonda NG, 60 (54%) gastrostomia e 31 (27,93%) PEG 13 .…”