Prognostic accuracy of preoperative nutritional indicators of survival in head and neck cancer patients

TL;DR

This study shows that nutritional indicators like BMI and muscle thickness predict survival in head and neck cancer patients undergoing surgery.

Contribution

The study evaluates the prognostic accuracy of multiple nutritional indicators in head and neck cancer patients.

Findings

The 5-year survival rate among HNC patients was 52.1%.

All nutritional indicators predicted survival, with triceps skinfold showing the highest accuracy at 74%.

Abstract

Head and neck cancer (HNC) patients are known to have high nutritional risk and a high prevalence of malnutrition. The diagnosis of HNC, together with sequelae and other consequences of cancer treatment, directly impacts survival.

To determine overall 5-year survival in HNC patients submitted to surgery as their initial treatment and to assess the prognostic accuracy of nutritional anthropometric measurements weight loss percentage (%WL), body mass index (BMI), triceps skinfold (TSF), adductor pollicis muscle thickness (APMT), and calf circumference (CC) to predict survival in this population.

A prospective cohort study of HNC patients treated at a cancer referral center in Bahia’s countryside was conducted.

Seventy-eight patients were included in this study and were followed up for a 5-year period, with an overall survival rate of 52.1%. Most patients were male (83.3%), with a median age of 65.5 years [55–72 years], and most had low education levels, low household income, and a lifestyle marked by alcohol drinking and tobacco smoking. Median values of all nutritional anthropometric variables assessed in this study were significantly lower among patients who died during follow-up, suggesting greater impairment of nutritional status in this group. All nutritional indicators were found to be predictors of survival in the study population, with a prognostic accuracy of 74% for TSF 95% CI [0.63–0.83], 68% for BMI 95% CI [0.56–0.78], 65% for CC 95% CI [0.53–0.75], 63% for APMT 95% CI [0.51–0.63], and 63% for %WL 95% CI [0.51–0.73].

The overall 5-year survival rate was found to be 52.1%, and all nutritional anthropometric variables, namely BMI, %WL, TSF, APMT, and CC, were found to be good predictors of survival in HNC patients initially treated with surgery.

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