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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.

Author information

1
a Department of Clinical Nutrition Therapy , Helsinki University Hospital , Helsinki , Finland.
2
b Department of Oncology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
3
c Children's Hospital, University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
4
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.
5
e Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland , Kuopio , Finland.
6
f Institute of Clinical Medicine, Internal Medicine, Kuopio University Hospital , Kuopio , Finland.
7
g Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology , Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden.
8
h Department of Otorhinolaryngology - Head & Neck Surgery , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.

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 < 0.001).

KEYWORDS:

Nutritional status; anthropometry; handgrip strength; oncology

PMID:
28125312
DOI:
10.1080/00016489.2016.1277263
[Indexed for MEDLINE]

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