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

术前营养指标对头颈癌患者生存预后的准确性

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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. AIM: 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. METHODS: A prospective cohort study of HNC patients treated at a cancer referral center in Bahia's countryside was conducted. RESULTS: 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]. CONCLUSION: 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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