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Acta Otolaryngol. 2017 Jul;137(7):778-785. doi: 10.1080/00016489.2016.1277263. Epub 2017 Jan 26.

Cachexia at diagnosis is associated with poor survival in head and neck cancer patients.

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a Department of Clinical Nutrition Therapy , Helsinki University Hospital , Helsinki , Finland.
b Department of Oncology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
c Children's Hospital, University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
d Laboratório de Nutrição e Unidade de Nutrição e Metabolismo, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Hospital Universitário de Santa Maria , Lisbon , Portugal.
e Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland , Kuopio , Finland.
f Institute of Clinical Medicine, Internal Medicine, Kuopio University Hospital , Kuopio , Finland.
g Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology , Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden.
h Department of Otorhinolaryngology - Head & Neck Surgery , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.



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.


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).


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.


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 < 0.001).


Nutritional status; anthropometry; handgrip strength; oncology

[Indexed for MEDLINE]

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