The Impact of Nutritional Status on the Prognoses of Patients with Advanced Head and Neck Cancer

Marian A. E. Bokhorst-de, Van der Schueren, Paul A. M. van Leeuwen, et. al.
Abramson Cancer Center of the University of Pennsylvania
Last Modified: November 1, 2001

Share article


Reviewers: Li Liu, MD
Source: Cancer, Volume 86, No 3 (August): 519-527, 1999.

Background

Nutritional support has long been known as an important part of multimodality treatment of head and neck cancer. Radiation therapy, chemotherapy, and surgery may increase the nutrient requirement and, at the same time, interfere with the patient?s ability to eat. Malnutrition is associated with higher cancer treatment-related morbidity and mortality. The prospective study from the Netherlands assessed the correlation of nutritional status with long-term outcome of patients with locally advanced head and neck cancers.

Methods

Sixty-four patients with stage T2-T4 histologically proven squamous cell carcinomas of head and neck were included in the study. Of those, 44 patients had previously untreated tumors. Twenty-eight patients underwent a total laryngectomy (removal of the larynx) and 36 patients underwent a composite resection of the primary tumor in the oral cavity or pharynx. Nutritional assessment prior to surgery included determination of the percentage of weight loss during the 6 months before treatment, the percentage of ideal body weight, serum albumin, total lymphocyte count, nutritional index, and bioelectrical impedance analysis. Minimum follow-up was 3 years.

Results

Overall survival was 55%, 47% for men and 76% for women. Statistical comparisons tests revealed no difference between men and women in terms of tumor stage and surgical procedure. However, other prognostic factors, such as performance status, co-morbidities, and history of smoking were not addressed. None of the investigated nutritional parameters correlated with survival. Males with more advanced nodal disease who had preoperative weight loss >5% had poorer survival.

Discussion

Nutritional parameters investigated in this study did not correlate with survival. Males with advanced nodal disease who had preoperative weight loss of >5% appeared to have a poore outcome. The difference in survival between men and women may be secondary to other prognostic factors, which were not addressed in the article.


News
Study IDs factors tied to outcomes in head, neck cancer patients treated with chemoradiotherapy

Dec 28, 2010 - Factors including gender, smoking history, cancer site, and age correlate with speaking and swallowing outcomes among patients successfully treated for locoregionally advanced cancers of the head and neck, according to a study published in the December issue of the Archives of Otolaryngology -- Head & Neck Surgery.



I Wish You Knew

How cancer patients have changed my life

View More



Blogs and Web Chats

OncoLink Blogs give our readers a chance to react to and comment on key cancer news topics and provides a forum for OncoLink Experts and readers to share opinions and learn from each other.




OncoLink OncoPilot

Facing a new cancer diagnosis or changing the course of your current treatment? Let our cancer nurses help you through!

Learn More