Cachexia at diagnosis is associated with poor survival in head and neck cancer patients |
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| Authors: | Helena Orell-Kotikangas Pia Österlund Outi Mäkitie Kauko Saarilahti Paula Ravasco Ursula Schwab |
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| Affiliation: | 1. Department of Clinical Nutrition Therapy, Helsinki University Hospital, Helsinki, Finland;2. helena.orell-kotikangas@hus.fi;4. Department of Oncology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;5. Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;6. Laboratório de Nutri??o e Unidade de Nutri??o e Metabolismo, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Hospital Universitário de Santa Maria, Lisbon, Portugal;7. Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland;8. Institute of Clinical Medicine, Internal Medicine, Kuopio University Hospital, Kuopio, Finland |
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| Abstract: | Conclusions: One third of the patients had cachexia with an association of significantly shorter survival. These results suggest that combining HGS and MAMA seems to be a practical method to screen cachexia in patients with head and neck cancer and may also be used when assessing their prognosis.Objectives: The aim of this study was to analyze the hypothesis that cachexia defined as both low mid-arm muscle area (MAMA) and handgrip strength (HGS) is associated with decreased survival in patients with head and neck squamous cell carcinoma (HNSCC).Methods: Sixty-five consecutive patients with primary HNSCC were enrolled prior to cancer therapy. Cachexia was defined as low handgrip strength (HGS) and low mid-arm muscle area (MAMA). Nutritional status was assessed by patient-generated subjective global assessment (PG-SGA) and sarcopenia by low MAMA. Biochemical parameters reflecting nutritional status and S-25-OHD were measured.Results: Cachexia was seen in 31% and sarcopenia in 46% of patients. Altogether, 34% of patients were malnourished. Disease-free survival was 13 months (3–62) in cachectic patients, compared with 66 months (31–78) in non-cachectic patients (p?=?0.009). S-25-OHD was 28?nmol/l in cachectic patients, compared with 46?nmol/l in non-cachectic patients (p?=?0.009) and prealbumin 187?mg/l and 269?mg/l, respectively (p?
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| Keywords: | Nutritional status handgrip strength anthropometry oncology |
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