Prevalence and prognostic significance of malnutrition in patients with cancers of the head and neck

Kubrak, Catherine; Martin, Lisa W.; Gramlich, Leah; Scrimger, Rufus; Jha, Naresh; Debenham, Brock; Chua, Neil; Walker, John; Baracos, Vickie E.

doi:10.1016/j.clnu.2019.03.030

Cited by 55 publications

(62 citation statements)

References 19 publications

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“…Thus, HNC patients have, when compared with patients with other primary tumours, many reasons to become underfed: the involvement of structures devoted to food intake, tumour-dependent anorexia, and finally the local toxicity of the oncologic therapy in addition to the common metabolic derangements. In conclusion, cancer-associated WL is driven by reduced food intake and altered metabolism, and amongst these two factors, reduced dietary intake is likely the predominant factor [12,23].…”

Section: Introductionmentioning

confidence: 93%

“…According to the experiences of some authors [12,14,47] an adequate regimen for a full nutritional support able to meet the requirements of the total energy expenditure should include ≥35 kcal/Kg/day and ≥1.5 g protein/Kg/day.…”

Section: The Nutritional Regimenmentioning

confidence: 99%

“…Cumulative weight losses may exceed 10% of pretreatment body weight [1][2][3] and WL of this magnitude is clinical as it contributes to prolonged hospitalization, forced treatment breaks [4], ineffective treatment response and impaired functional performance status, finally leading to reduced quality of life (QoL) and significantly lower survival [4][5][6][7][8][9][10][11]. In a large multivariable analysis of 1756 HNC patients [12] controlled for age, sex, cancer stage and site and performance status, both the weight loss grading system (a grading system based on combinations of body mass index and WL [13]) and dietary intake categories independently predicted overall survival.…”

Section: Introductionmentioning

confidence: 99%

“…Naïve HNC patients present during oncologic treatment a variety of symptoms (dysphagia, odynophagia, and anorexia) which lead to insufficient dietary intake and declining body weight [9]. A recent large study [12] reported that independent predictors of WL in naïve HNC patients included stage, performance status, and dietary intake.…”

Section: Introductionmentioning

confidence: 99%

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Nutritional Issues in Head and Neck Cancer Patients

Bozzetti

Cotogni

2020

Healthcare

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The purpose of this paper is to update the oncologist on the correct approach to the nutritional care of the head and neck cancer patient. Recent scientific contributions on this issue, with a special emphasis on international guidelines and randomised clinical trials (RCTs), are reviewed. The following points are noteworthy: 1. Despite the advances in early diagnosis and modern treatment of head and neck cancer, this tumour still ranks first regarding frequency and severity of weight loss, both at the clinical presentation and during the therapy. 2. This is due to the combination of poor alimentation because of the tumour mass localization, as well as of the presence of an inflammatory response which furtherly drives catabolism. 3. Several studies have shown a very limited role for a dietary counselling unless it includes oral nutritional supplements which are protein or omega-3 fatty acid enriched. 4. A parental nutritional supplementation could represent an acceptable short-term alternative. 5. Long-term nutritional support relies on the use of percutaneous endoscopic gastrostomy (PEG), whereas the role of a prophylactic or “a la demande” PEG is still unsettled and requires further investigations. In conclusion, the nutritional approach using specific formulas and the appropriate route of administration should be part of the therapeutic armamentarium of the modern oncologist.

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Section: Introductionmentioning

confidence: 93%

Section: The Nutritional Regimenmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nutritional Issues in Head and Neck Cancer Patients

Bozzetti

Cotogni

2020

Healthcare

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“…Nutritional assessment supports and institutional awareness, may favour early nutritional intervention on nutritional status [21] [22]. Awareness of this fact is of major importance when establishing a treatment and follow-up schemes in HNC patients.…”

Section: Discussionmentioning

confidence: 99%

Head and Neck Cancer Early Identification of Malnutrition High Risk Patients and Quality of Life Optimization

Silva¹,

Silveira²,

Sacau³

et al. 2019

IJOHNS

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Malnutrition in Head and neck cancer (HNC) patients can be present at the moment of diagnosis. The nutritional status is determinant for the treatment success and quality of life of the patients. The nutritional status gradually declines during treatment and the majority of patients undergoing treatment will need nutritional therapy. On the other hand, HNC, like other cancers, can induce a paraneoplastic syndrome that leads to cachexia. This cachexia status is most of the times the cause of death or the cause of treatment failure. So, early identification of malnutrition high risk patients is crucial to start an adequate nutrition support intervention in HNC patients. This study aims to identify HNC patients who present malnutrition or higher risk of malnutrition; to signalize variables that support early identification of high-risk patients of becoming malnourished and to establish a dynamic relationship between malnutrition risk in these patients and Quality of Life (QoL) impacts. For six months consecutive outpatients with HNC admitted at the Head & Neck Unity of Oncology Portuguese Institute-Porto were asked to participate in the research (n = 114). The European Organisation for Research and Treatment of Cancer (EORTC) cancer-specific HRQoL questionnaire-QLQ-C30 and Malnutrition Universal Screening Tool, MUST were used. At the moment of first presentation, 32 patients (28.1%) presented high-risk of malnutrition. HNC patients with oral cavity and oropharynx tumour locations, older, with low literacy or with BMI under 18.5 at the moment of diagnosis, represent a high-risk group. When HNC is considered, a dynamic and bi-directional connection between malnutrition and QoL is observed. A significant (p < 0.001) difference in the scores of Global health status/QoL according to the malnutrition risk group was found: 62.96, 53.33, 42.

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Predictive effect of pretreatment nutritional risk and GLIM‐defined malnutrition on the nutrition impact symptom clusters in patients with head and neck cancer undergoing radiotherapy

Wang

Zhang

et al. 2022

Head & Neck

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Background Evidence supporting predictive effects of pretreatment nutritional risk and nutritional status on nutrition impact symptom (NIS) clusters during radiotherapy in patients with head and neck cancer (HNC) is insufficient. Methods At baseline (T1), we collected severity and interference of NIS (Head and Neck Patient Symptom Checklist), nutritional risk, and nutritional status. During (T2) and at the end of radiotherapy (T3), we re‐evaluated NIS. Symptom clusters were identified by exploratory factor analysis using mean scores of NIS severity at T2 and T3. Predictive effects were explored by generalized estimating equations. Results Five hundred thirty‐seven patients were recruited and 334 of them completed. Four clusters were identified; the oropharyngeal symptom cluster was the most severe and had the greatest interference with diet. Patients with pretreatment nutritional risk or malnutrition experienced more severe oropharyngeal symptom cluster. Conclusions Pretreatment nutritional risk or malnutrition could predict the oropharyngeal symptom cluster in patients with HNC undergoing radiotherapy.

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Prevalence and prognostic significance of malnutrition in patients with cancers of the head and neck

Cited by 55 publications

References 19 publications

Nutritional Issues in Head and Neck Cancer Patients

Nutritional Issues in Head and Neck Cancer Patients

Head and Neck Cancer Early Identification of Malnutrition High Risk Patients and Quality of Life Optimization

Predictive effect of pretreatment nutritional risk and GLIM‐defined malnutrition on the nutrition impact symptom clusters in patients with head and neck cancer undergoing radiotherapy

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