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

Abstract

BACKGROUND Malnutrition has been recognized as a poor prognostic indicator for cancer treatment–related morbidity and mortality in general, and it is reported to affect 30–50% of all patients with head and neck cancer. In this study, the correlation of nutritional status with 3‐year survival was studied prospectively in 64 patients with T2–T4 carcinomas of the head and neck who were treated surgically with curative intent; the surgery was often followed by radiotherapy. METHODS All patients underwent nutritional screening according to six different parameters on the day prior to surgery. Overall and disease specific survival analyses were performed with a follow‐up period of at least 3 years. Survival analyses were performed with the log rank test and the Cox proportional hazards model. RESULTS Lymph node stage, nonradical resection margins, and occurrence of major postoperative complications were demonstrated to affect disease specific survival for the group as a whole. None of the investigated nutritional parameters were correlated with survival. When men and women were analyzed separately, however, a preoperative weight loss of >5% did have a prognostic value for men. The combination of male gender, preoperative weight loss, and major postoperative complications were related to early death. CONCLUSIONS Apart from the well‐known prognostic parameters lymph node status (T classification) and status of surgical margins, preoperative weight loss and occurrence of major postoperative complications were also found to have a negative effect on the survival of male patients undergoing surgery for advanced head and neck cancer. Cancer 1999;86:519–27. © 1999 American Cancer Society.

Predictors of radiotherapy outcome in patients with T2 supraglottic carcinoma

“…The relation between weight loss and survival has been demonstrated by several authors [29][30][31][32][33]. It seems to be true also for patients with early supraglottic cancer, the more so as leanness was proved to be an indicator of laryngeal cancer risk [34].…”

Weight loss in cancer patients: a plea for a better awareness of the issue

“…Weight loss has been shown to have both a prognostic [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] and a predictive relevance [16,[19][20][21][22][23][24] and its presence is associated with deterioration of the quality of life [20,25,26].…”

Effect of oral nutritional supplementation on weight loss and percutaneous endoscopic gastrostomy tube rates in patients treated with radiotherapy for oropharyngeal carcinoma

“…Up to 30-50% of head and neck cancer patients are malnourished at the time of diagnosis [25]. These patients have complex nutritional problems due to both tumor-related and treatment-induced symptoms.…”