Bioelectrical Impedance Phase Angle as a Prognostic Indicator of Survival in Head-and-Neck Cancer

Wladysiuk, M; Mlak, Radosław; Morshed, Kamal; Surtel, Wojciech; Brzozowska, Anna; Małecka‐Massalska, Teresa

doi:10.3747/co.23.3181

Cited by 37 publications

(13 citation statements)

References 49 publications

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“…The median PA at diagnosis for all patients was 5.91°, which was similar as in a previous study of mixed cancer patients with a median PA at 5.95° [29]; however, in two studies, one on breast cancer [15] and one on colorectal cancer [30], the median PA was lower at 5.6°; and one study on patients with HN cancer identified a lower mean PA of 5.04° [31]. In the current study, PA was a significant prognostic factor for survival at uni- and multivariable analyses.…”

Section: Discussionsupporting

confidence: 83%

Bioelectrical phase angle at diagnosis as a prognostic factor for survival in advanced head and neck cancer

Axelsson

Silander

Bosæus

2018

Eur Arch Otorhinolaryngol

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ObjectiveBioelectrical impedance analysis (BIA) is used to measure the patient’s body composition, fat-free mass, phase angle (PA), and standardized phase angle (SPA), which are affected by malnutrition. Low values of PA and SPA have been found to be negative prognostic factors for survival in different types of cancer and other severe diseases. The aim of the current study was to investigate whether PA and SPA can be used to predict survival in head and neck (HN) cancer.MethodsOne hundred twenty-eight patients with advanced HN cancer treated in Western Sweden 2002–2006 were examined with BIA at diagnosis, and PA and SPA were calculated. Patients’ age, gender, tumor site, TNM stage, and performance status were obtained, and weight, height, and BIA were measured. Survival up to 12 years was ascertained.ResultsThe mean PA was 5.85° and the median was 5.91°. Lower PA and SPA values were significantly associated with shorter overall survival in univariate analyses, together with higher age, oral cancer, higher T class, worse performance status, more weight loss before diagnosis, lower: weight, height, BMI, and reactance. Age, performance status, T class, and PA were significant factors for the overall survival in the multivariable analysis. A PA cutoff value at 5.95° provided the best prediction of 5-year survival.ConclusionsPA and SPA at diagnosis are significant factors for survival in patients with advanced HN cancer. They are promising prognostic tools to use in treatment planning; further studies are needed.

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Section: Discussionsupporting

confidence: 83%

Bioelectrical phase angle at diagnosis as a prognostic factor for survival in advanced head and neck cancer

Axelsson

Silander

Bosæus

2018

Eur Arch Otorhinolaryngol

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“…BIA was demonstrated to correlate with the results obtained from DXA and magnetic resonance tomography [ 34 , 72 , 73 ]. Investigations estimating the reliability of measured body composition parameters by BIA and the wide application range of this technology, also in cancer patients, warranted the use within our study [ 50 , 74 , 75 ]. A huge advantage of the seca instrument that we used in this study is that BIA can be performed easily and very quickly by clinical staff, without distressing patients by elaborated and time-consuming measurement techniques or exposing them to X-rays [ 76 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of whole-body electromyostimulation combined with individualized nutritional support on body composition in patients with advanced cancer: a controlled pilot trial

et al. 2018

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BackgroundPhysical exercise and nutritional treatment are promising measures to prevent muscle wasting that is frequently observed in advanced-stage cancer patients. However, conventional exercise is not always suitable for these patients due to physical weakness and therapeutic side effects. In this pilot study, we examined the effect of a combined approach of the novel training method whole-body electromyostimulation (WB-EMS) and individualized nutritional support on body composition with primary focus on skeletal muscle mass in advanced cancer patients under oncological treatment.MethodsIn a non-randomized controlled trial design patients (56.5% male; 59.9 ± 12.7 years) with advanced solid tumors (UICC III/IV, N = 131) undergoing anti-cancer therapy were allocated to a usual care control group (n = 35) receiving individualized nutritional support or to an intervention group (n = 96) that additionally performed a supervised physical exercise program in form of 20 min WB-EMS sessions (bipolar, 85 Hz) 2×/week for 12 weeks. The primary outcome of skeletal muscle mass and secondary outcomes of body composition, body weight and hand grip strength were measured at baseline, in weeks 4, 8 and 12 by bioelectrical impedance analysis and hand dynamometer. Effects of WB-EMS were estimated by linear mixed models. Secondary outcomes of physical function, hematological and blood chemistry parameters, quality of life and fatigue were assessed at baseline and week 12. Changes were analyzed by t-tests, Wilcoxon signed-rank or Mann-Whitney-U-tests.ResultsTwenty-four patients of the control and 58 of the WB-EMS group completed the 12-week trial. Patients of the WB-EMS group had a significantly higher skeletal muscle mass (0.53 kg [0.08, 0.98]; p = 0.022) and body weight (1.02 kg [0.05, 1.98]; p = 0.039) compared to controls at the end of intervention. WB-EMS also significantly improved physical function and performance status (p < 0.05). No significant differences of changes in quality of life, fatigue and blood parameters were detected between the study groups after 12 weeks.ConclusionsSupervised WB-EMS training is a safe strength training method and combined with nutritional support it shows promising effects against muscle wasting and on physical function in advanced-stage cancer patients undergoing treatment.Trial registrationClinicalTrials.gov NCT02293239 (Date: November 18, 2014).

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“…PhA is used as an indicator of cellular health in relation to imbalance of cellular water and integrity of the cell membrane [8]. However, the PhA value can be negatively influenced by several clinical diseases, such as malnutrition [9], diabetes [10], human immunodeficiency virus infection (HIV infection) [11], and some types of cancer [12,13]. Healthy individuals show higher values of PhA (higher than 5º), indicating better cellular health and cell membrane integrity compared to malnourished patients [9].…”

Section: Introductionmentioning

confidence: 99%

Phase Angle is Determined by Body Composition and Cardiorespiratory Fitness in Adolescents

et al. 2020

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The phase angle is used to evaluate nutritional status and is an indicator of cellular health. Cardiorespiratory fitness and body composition are strong indicators of health during adolescence. We aimed to evaluate if body composition and cardiorespiratory fitness have an association with phase angle among adolescents. 203 girls and 220 boys (12.8±1.3 years) were evaluated. Peak height velocity, percentage fat mass, fat-free mass, cardiorespiratory fitness, and phase angle measurements were collected. Linear regression adjusted by peak height velocity was used to verify if predictor variables were associated with phase angle among adolescents. Phase angle showed correlation with fat-free mass (girls: r=0.42 and boys: r=0.37); with percent fat mass (girls: r=0.23); and with cardiorespiratory fitness (boys: r=0.19). Linear regression showed that percentage fat mass (in girls) and cardiorespiratory fitness (in boys) had an effect of 11 and 17% in phase angle, respectively, while fat-free mass had an effect of 22 and 26% in phase angle for girls and boys, respectively. Changes in phase angle seem to be more associated with the percentage fat mass in girls, cardiorespiratory fitness in boys, and fat-free mass in both when controlled by peak height velocity.

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Bioelectrical Impedance Phase Angle as a Prognostic Indicator of Survival in Head-and-Neck Cancer

Abstract: Background Phase angle could be an alternative to subjective global assessment for the assessment of nutrition

Cited by 37 publications

References 49 publications

Bioelectrical phase angle at diagnosis as a prognostic factor for survival in advanced head and neck cancer

Bioelectrical phase angle at diagnosis as a prognostic factor for survival in advanced head and neck cancer

Effects of whole-body electromyostimulation combined with individualized nutritional support on body composition in patients with advanced cancer: a controlled pilot trial

Phase Angle is Determined by Body Composition and Cardiorespiratory Fitness in Adolescents

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