Nutritional support and prognosis in patients with head and neck cancer

Abstract

We retrospectively studied the relationship between nutritional status as indicated by the presence or absence of the cutaneous delayed hypersensitivity response and treatment-related morbidity, disease recurrence, and survival at 2 years in 67 consecutive patients with head and neck carcinoma. Serial nutritional assessments were conducted throughout the course of combined initial antineoplastic treatment and nutritional support. The presence of cell-mediated immunity at the end of treatment was associated with a 2-year survival rate of 100%, whereas patients who were anergic at the end of treatment had a 2-year survival rate of 48% (P < 0.01). Morbidity due to surgical therapy and tumor recurrence rates were also higher in the anergic group (P < 0.01). Prognosis in head and neck cancer is based on many factors, but vigorous nutritional support during initial treatment may have some effect on morbidity, tumor recurrence, and survival time.

The impact of nutritional status on the prognoses of patients with advanced head and neck cancer

“…Lopez et al retrospectively studied the correlation between immunocompetence and morbidity, tumor recurrence, and survival at 2 years for 67 head and neck cancer patients undergoing surgery in conjunction with postoperative radiotherapy. 38 Those authors found a 100% survival rate for patients with a normal immunologic response and a 48% survival rate for patients with an absent cutaneous delayed hypersensitivity response. Apart from the rather unusual observation of a 100% survival rate, the results of this study must also be interpreted with caution because impaired immunocompetence is not by definition synonymous with malnutrition.…”

Quality of life and home enteral tube feeding: a French prospective study in patients with head and neck or oesophageal cancer

“…It may decrease the response to chemotherapy as well as the tolerance to both radio and chemotherapy (Dewys et al, 1980;Vigano et al, 1994). Artificial nutrition can limit the risk of malnutrition although it is unable to restore a severely altered nutritional state (Lipman, 1991;Lopez et al, 1994;Société Française de Nutrition Entérale et Parentérale et Société Française d'Anesthésie Réanimation, 1995;Shike, 1996;Souba, 1997;Barber et al, 1998). Enteral tube feeding (ETF) is the method of choice in patients with functional digestive tract (Campos et al, 1990;Boyd and Beeken, 1994;Bozetti, 1994;Société Française de Nutrition Entérale et Parentérale et Société Française d'Anesthésie Réanimation, 1995).…”

“…ETF-related complications are uncommon, the most frequent being diarrhoea (Coben et al, 1994; Société Française de Nutrition Entérale et Parentérale et Société Française d'Anesthésie Réanimation, 1995). Acute aspiration pneumonia is rare and can easily be avoided (Lopez et al, 1994).…”

Near-Total Laryngectomy in Advanced Cancers of the Larynx and Pyriform Sinus: A Comparative Study of Morbidity and Functional and Oncological Outcomes

“…This prospective study addresses the outcome of near-total laryngectomy in 54 consecutive advanced lesions of the larynx (14) or pyriform sinus (40) carried out by the senior author (A.M.S.) 12,13 Therefore, these procedures may be better avoided in clinical situations with a high potential for infection, such as radiotherapy failure and obstructive lesions in patients with prior tracheotomies. An earlier report from this center attested to the therapeutic efficacy of this surgical procedure, with satisfactory speech restoration with no tracheobronchial aspiration.f Before 1988, these patients would have undergone totallar-Shunt stenoses Shunt denervation Aspiration advantage (in >80%), without troublesome tracheobronchial aspiration (<10%), has indeed made this procedure worth the marginally increased hospital stay, Attention is being directed to minimizing the local wound problems that mar the convalescence, especially in patients with pyriform sinus lesions.…”