Nutritional Status‐a Prognostic Indicator in Head and Neck Cancer

Abstract

A prospective study into the nutritional status of 114 patients with untreated primary squamous cell carcinoma of the head and neck was undertaken to assess its possible prognostic value for survival. Nutritional status was evaluated by anthropometry, creatinine height index estimation, serum albumin and transferrin assays, and nitrogen balance studies. Weight change and other anthropometric indices found to be the most reliable nutritional parameters were averaged to derive a clinically useful, general nutritional status score. A nutritional deficit was found in 43 of the 114 patients (37.7%) and was associated with neoplasms of the upper gastrointestinal tract in more than 80% of the patients. Life table analysis showed a statistically very highly significant difference between the survival of the adequately nourished patients (57.5% at 2 years) and the survival of the undernourished patients (7.5% at 2 years) (chi 2 = 36.08; P = .0). These results indicate that nutritional deficiency is an important adverse prognostic factor in head and neck cancer. Undernutrition probably exerts its effect, at least in part, by causing secondary immunologic dysfunction.

Critical weight loss in head and neck cancer—prevalence and risk factors at diagnosis: an explorative study

“…Critical weight loss (CWL), defined as the involuntary weight loss of ≥5% in 1 month or ≥10% in 6 months, is a common phenomenon in head and neck cancer patients because it is present in about 30% to 55% of these patients [5,17,19,28]. CWL is clinically of utmost importance.…”

Pretreatment serum albumin: a prognostic indicator of survival in oral cancer

“…31 Liu S et al also demonstrated that pretreatment serum albumin levels are independent indicator of prognosis for patients with oral cavity cancer. 34 A prospective cohort study of 170 patients with advanced cancer, where lung (34%), liver (14%), and lower gastrointestinal tract (14%) malignancies accounted for almost two thirds of the primary cancers, enrolled into the palliative care unit of a regional hospital in Hong Kong demonstrated that serum albumin is an independent predictor of survival.…”

“…A vast majority (>70%) of more than one billion population of India lives in rural areas, which have inadequate access to trained providers and limited health services. As a result, most of the cases are diagnosed at later stages which result in low treatment outcomes and poor 5-year survival rate of approximately 37% (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45). 2 Various clinical, biochemical, and histological prognostic factors have been identified in the literature, some generic to all cancers and some specific for oral cavity cancer.…”

“…However, the studies were not limited to primary oral cancer and focused on pre-operative weight and calculation of nutritional status score. [29][30][31] Therefore, the present study was carried out to investigate whether pretreatment serum albumin levels could be simple predictors for the survival of patients with oral cancer.…”

Optimising nutrition support in patients with head and neck cancer

“…Nutritional status has long been recognised as the second most important factor in predicting long-term prognosis in HNC (Brookes, 1985). The consequences of malnutrition in HNC patients have been widely studied and include:…”