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

**Authors:** Neyara dos Santos Oliveira, Tercio Guimarães Reis, Milena Souza Freitas, Marluce Matos Macêdo, Jean Carlos Zambrano Contreras, Márcio Campos Oliveira, José Bessa Júnior

PMC · DOI: 10.7717/peerj.19496 · 2025-06-26

## 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.

## Key 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.

## Linked entities

- **Diseases:** head and neck cancer (MONDO:0005627)

## Full-text entities

- **Diseases:** impairment of nutritional status (MESH:D009748), died (MESH:D003643), HNC (MESH:D006258), malnutrition (MESH:D044342), weight loss (MESH:D015431), cancer (MESH:D009369)
- **Chemicals:** alcohol (MESH:D000438)
- **Species:** Nicotiana tabacum (American tobacco, species) [taxon 4097], Homo sapiens (human, species) [taxon 9606]

## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12206401/full.md

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Source: https://tomesphere.com/paper/PMC12206401