Nutrition management for head and neck cancer patients improves clinical outcome and survival

Müller‐Richter, Urs; Betz, Christian; Hartmann, Stefan; Brands, Roman C.

doi:10.1016/j.nutres.2017.08.007

Cited by 94 publications

(92 citation statements)

References 65 publications

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“…Just like in the functional scales, when considering the symptom scales, no differences were found between medium and low risk patients. We found the majority of HNC patients had low risk of malnutrition (63.2%), a clear contrast to values often described in the literature referring up to 80% malnourished because of their lifestyle and the risk factors associated with this disease [18]. Such difference may be explained by the fact that assessment occurred when patients were admitted at the Head & Neck Unity, before any treatment [19] [20].…”

Section: ) Hnc Patients' Characteristicscontrasting

confidence: 73%

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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Section: ) Hnc Patients' Characteristicscontrasting

confidence: 73%

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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“…increasing nutrition intake, aerobic and resistance exercise, and physical activity while decreasing inflammation and hypermetabolic stress. 21,22 Guided by various measurements of malnutrition, we collected data on body mass index, lean body muscle, body surface area and estimated lumbar SMI for the analyses. However, low SMM was the only independent predictor of lower survival.…”

Section: Ta B L E 2 (Continued)mentioning

confidence: 99%

Sarcopenia results in poor survival rates in oral cavity cancer patients

Lin

Kang

et al. 2020

Clinical Otolaryngology

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Objective This study aimed to determine the impact or survival of low skeletal muscle mass (SMM) among patients with oral squamous cell carcinoma (OSCC) undergoing primary surgery. Design This study was a retrospective cohort study. Setting Oral squamous cell carcinoma patients treated at our referral centre from April 2005 to March 2014 were examined. Participants The cohort comprised 276 patients with OSCC undergoing primary surgery. Main outcome measures Estimated SMM was measured by calculating the cervical skeletal muscle mass from a CT scan of the head and neck. The 5‐year overall survival (OS) and disease‐specific survival (DSS) were analysed using a multivariable Cox regression model. Results There were 276 patients with a male‐to‐female ratio of 12:1. A low SMM (<47.5 cm2/m2) was associated with worse survival. After adjustment for other factors, the result remained robust for OS (hazard ratio [HR] 1.74, 95% confidence interval [CI] 1.14‐2.67) and disease‐specific survival (HR 1.67, 95% CI 1.04‐2.67). In the subgroup analysis, worse OS and DSS were particularly noted in male patients (HR = 1.90, 95% CI 1.22‐2.97; HR = 1.91, 95% CI 1.27‐3.19) and in those younger than 60 years of age (HR = 1.91, 95% CI 1.14‐3.22; HR = 2.12, 95% CI 1.23‐3.64) with low SMM. Conclusions Low SMM was a significant independent factor that was associated with lower survival in patients who have oral cavity cancers and are undergoing primary surgery. Preoperative CT scans of the head and neck could be utilised to evaluate SMM, predict treatment outcomes and facilitate nutrition management.

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“…It is also associated with improved surgical outcomes and disease survival. 17 Other important considerations in the immediate postoperative period include prophylaxis against thromboembolism, antibiotic prophylaxis, nausea and vomiting prevention, and intravenous fluid management.…”

Section: Perioperative Care Of the Mandibular Reconstruction Patientmentioning

confidence: 99%

Free-Flap Reconstruction of the Mandible

Kim

Sokoya

Ducic

et al. 2019

Seminars in Plastic Surgery

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Mandible reconstruction has evolved over the years with advances in surgical options and three-dimensional technology. Although nonvascularized bone grafting is still used, vascularized flaps show advantages with immediate reconstruction, the possibility of immediate dental implants, and the ability to reconstruct composite defects of both soft tissue and bone. This article discusses current vascularized techniques for mandible reconstruction. While each reconstructive method has advantages and disadvantages, a defect-based reconstruction focused on full rehabilitation allows surgeons to plan and counsel the patient for the best available reconstruction.

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Nutrition management for head and neck cancer patients improves clinical outcome and survival

Cited by 94 publications

References 65 publications

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

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

Sarcopenia results in poor survival rates in oral cavity cancer patients

Free-Flap Reconstruction of the Mandible

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