The nutritional assessment of head and neck cancer patients

Abstract

Patients affected by head and neck cancer are particularly at risk for nutritional depletion. The aim of this study was to evaluate the nutritional status of patients affected by head and neck cancer at diagnosis. All adult patients with head and neck cancer between January 2009 and December 2013 were included. The following data were recorded: demographics, tobacco and/or alcohol consumption, weight, height, the reference weight 6 months before the diagnosis, tumor site, tumor stage, and laboratory data. Then, Body mass index (BMI), and Buzby nutrition risk index (NRI) were calculated. Statistical analysis was used to search for associations among multiple variables. 122 men and 22 women were enrolled. As for reference BMI, 77 patients were overweight, whereas just 7 subjects were underweight. At diagnosis, 72 subjects were overweight according to BMI, whereas 52 patients were underweight. Instead, according to NRI, 96 patients were severely malnourished, 42 patients were moderately malnourished, whereas just 6 patients had a normal value of NRI. The assessment of nutrition by BMI excluded from a thorough consideration all overweight and obese patients with head and neck cancer. Instead, NRI correctly identified both undernourished and overweight/obese patients as "malnourished" subjects.

Disease‐induced and treatment‐induced alterations in body composition in locally advanced head and neck squamous cell carcinoma

“…Despite different cut‐off points for male and female patients, a significantly higher proportion of muscle wasting was found in the female subjects. The present literature does not provide an explanation for this difference . In the present cohort, a significant difference in the distribution of P16+ oropharyngeal tumours was observed between muscle‐wasted and non‐wasted patients.…”

“…The present literature does not provide an explanation for this difference. 9,10,36,37 In the present cohort, a significant difference in the distribution of P16+ oropharyngeal tumours was observed between muscle-wasted and non-wasted patients. In the P16+ oropharyngeal tumour group, lower numbers of wasted patients were seen at the start of CRT/BRT.…”

Association between nutritional risk index and outcomes for head and neck cancer patients receiving concurrent chemo‐radiotherapy

“…Some of the factors contributing to malnutrition include poor socio-economic status, chronic substance abuse, and tumor related symptoms such as odynophagia and dysphagia. 3,4 Acute toxicities associated with curative chemotherapy and radiation therapy, such as fatigue, nausea, mucositis, xerostomia, dysgeusia, and worsening dysphagia or odynophagia can contribute further to poor oral intake and weight loss. [5][6][7] Studies have shown that a notable percentage of malnourished HNC patients have adverse outcomes, such as increased mortality, infection and decreased treatment completion rate.…”

“…[5][6][7] Studies have shown that a notable percentage of malnourished HNC patients have adverse outcomes, such as increased mortality, infection and decreased treatment completion rate. 4,5,8 There are a few validated scoring systems to measure the severity of malnutrition in clinical settings, one of which is Nutritional Risk Index (NRI). The formula for NRI incorporates present weight, ideal body weight based on gender and height, and serum albumin level, which are information available for most patients prior to treatment.…”

Head and Neck Cancer Adherence to Dietary Recommendations using Theory-Based Tools: Future Research Directions

“…Not only do these populations vary in sociodemographic characteristics, but also those diagnosed with HPV-positive HNCa have better disease outcomes following treatment [4]. Knowing disease etiology plays a large role in whether patients need dietary guidance, especially since HPV-positive HNCa patients are less likely to be at nutritional risk [5]. Lastly, future studies should assess alcohol and tobacco use, as HPV-negative HNCa patients are more likely to be current users or have a history of alcohol and tobacco use [6].…”