Studying Malnutrition-Related Factors in Patients with Head and Neck Cancer Following Surgery
Journal of Otorhinolaryngology and Facial Plastic Surgery,
Vol. 5 No. 2 (2019),
1 December 2019
,
Page 1-8
https://doi.org/10.22037/orlfps.v5i2.28008
Abstract
Background: Nutritional dysfunction with or without aspiration is a common complication following head and neck cancer (HNC) surgery and patients frequently present with weight loss secondary to dysphagia and malnutrition.
Aim: The aim of this study was to investigate the incidence of weight loss and malnutrition in patients with HNC following surgery through the Malnutrition Universal Screening Tool (MUST) scale.
Methods: A total of 28 patients with a confirmed diagnosis of head and neck cancer mainly of the oral cavity referring for surgery for the first time were enrolled. A researcher-designed questionnaire was used for data collection. Further, a single nutritionist evaluated each patient’s nutritional status before and 6-8 weeks' post-surgery according to MUST to measure the level of malnutrition. Significance level was set at p<0.05.
Results: Among the subjects, 57% were younger than 70 years; 61% were in stage II of cancer while the rest were in stage III. Weight, body mass index (BMI), serum hemoglobin, and albumin levels showed a significant reduction following surgery (p<0.05). Specifically, 18% had less than 5%, 36% had 5-10%, and 46% had >10% weight loss. According to MUST scale, 18% of Patients with HNC had low, 25% had moderate, and 57% had high risk of malnutrition. A significant relationship was found between severe malnutrition and patients older than 70 years of age.
Conclusion: In head and neck cancer patients, weight loss increases the morbidity and mortality, therefore nutritional interventions should be initiated before cancer treatment begins and these interventions need to be ongoing after completion of treatment to ensure optimal outcome.- Head and Neck Cancer (HNC)
- Malnutrition
- Malnutrition Universal Screening Tool
- MUST
- Surgery
- Weight loss
How to Cite
References
Van Cutsem E, Arends J. The causes and consequences of cancer associated malnutrition. Eur J Oncol Nurs. 2005, 9:S51–S63. Suppl 2:S51-63.
Lis CG, Gupta D, Lammersfeld CA, Markman M, Vashi PG. Role of nutritional status in predicting quality of life outcomes in cancer-a systematic review of the epidemiological literature. Nutr J. 2012;11:27.
Tong H, Isenring E, Yates P. The prevalence of nutrition impact symptoms and their relationship to quality of life and clinical outcomes in medical oncology patients. Support Care Cancer. 2009;17:83–90.
Jager-Wittenaar H, Dijkstra PU, Vissink A, van Oort RP. van der laan BF, Roodenburg JL. Malnutrition in patients treated for oral or oropharyngeal cancer–prevalence and relationship with oral symptoms: an explorative study. Support Care Cancer. 2010;16.
van den Berg MG. rasmussen-Conrad EL, Gwasara GM, Krabbe Pf, Naber AH, Merkx MA (2006) A prospective study on weight loss and energy intake in patients with head and neck cancer, during diagnosis, treatment and revalidation. Clin Nutr.;25:765-72.
Pressoir M, Desné S, Berchery D, Rossignol G, Poiree B, Meslier M, Traversier S, et al. Prevalence, risk factors and clinical implications of malnutrition in French Comprehensive Cancer Centres. Br J Cancer. 2010;102(6):966-71.
Chasen MR, Bhargava R. A descriptive review of the factors contributing to nutritional compromise in patients with head and neck cancer. Support Care Cancer. 2009;17:1345-51.
Ehrsson YT, Langius-Eklöf A, Laurell G. Nutritional surveillance and weight loss in head and neck cancer patients. Support Care Cancer. 2012;20(4):757-65.
Jager-Wittenaar H, Dijkstra PU, van der Laan BFAM, Vissink A, van Oort RP, Roodenburg JLN. Critical weight loss in head and neck cancer patients—prevalence and risk factors at diagnosis: an explorative study. Supp Care Cancer. 2007;15:1045–50.
Kubrak C, Olson K, Jha N, Jensen L, McCargar L, Seikaly H, Harris J, Scrimger R, Parliament M, Baracos VE. Nutrition impact symptoms: key determinants of reduced dietary intake, weight loss, and reduced functional capacity of patients with head and neck cancer before treatment. Head Neck. 2010;32(3):290–300.
Holder H. Nursing management of nutrition in cancer and palliative care. Br J Nurs. 2003;12:667–668, 670, 672–4.
Ouwens MM, Hermens RR, Hulscher MM, et al. The causes and consequences of cancer associated malnutrition. Eur J Oncol Nurs. 2009;31:902-10.
McRackan TR, Watkins JM, Herrin AE, et al. Effect of body mass index on chemoradiation outcomes in head and neck cancer. Laryngoscope. 2008;118:1180–5.
List MA, Bilir SP. Functional outcomes in head and neck cancer. Semin Radiat Oncol. 2004;14:178-89.
Vissink A, Jansma J, Spijkervet FK, Burlage FR, Coppes RP. Oral sequelae of head and neck radiotherapy. Crit Rev Oral Biol Med. 2003;14:199-212.
Arends J, Bodoky G, Bozzetti F, Fearon K, Muscaritoli M, Selga G, et al. ESPEN Guidelines on Enteral Nutrition: Nonsurgical oncology. Clin Nutr. 2006;25:245-59.
Datema FR, Ferrier MB, Baatenburg de Jong RJ. Impact of severe malnutrition on short-term mortality and overall survival in head and neck cancer. Oral Oncol. 2011;47(9):910-4.
Alshadwi A, Nadershah M, Carlson ER, Young LS, Burke PA, Daley BJ. Nutritional Considerations for Head and Neck Cancer Patients: A Review of the Literature. J Oral Maxillofacial Surg. 2013;71(11):1853-60.
van den Berg MG, Rasmussen-Conrad EL, van Nispen L, van Binsbergen JJ, Merkx MA. A prospective study on malnutrition and quality of life in patients with head and neck cancer. Oral Oncol. 2008;44(9):830-7.
Capuano G, Gentile PC, Bianciardi F, Tosti M, Palladino A, Di Palma M. Prevalence and influence of malnutrition on quality of life and performance status in patients with locally advanced head and neck cancer before treatment. Support Care Cancer. 2010;18(4):433-7.
De Graeff A, de Leeuw R, Ros W. Pre-treatment factors predicting quality of life after treatment for head and neck cancer. Head Neck. 2000;22:398.
Ottosson S, Zackrisson B, Kjellén E, Nilsson P, Laurell G. Weight loss in patients with head and neck cancer during and after conventional and accelerated radiotherapy. Acta Oncol. 2013;52(4):711-8.
Pai PC, Chuang CC, Tseng CK, Tsang NM, Chang KP, Yen TC, et al. Impact of pretreatment body mass index on patients with head-and-neck cancer treated with radiation. Int J Radiat Oncol Biol Phys. 2012;83(1):e93-e100.
Gaudet MM, Patel AV, Sun J, Hildebrand JS, McCullough ML, Chen AY, et al. Prospective studies of body mass index with head and neck cancer incidence and mortality. Cancer Epidemiol Biomarkers Prev. 2012; 21(3):497-503.
Langius JA, Bakker S, Rietveld DH, Kruizenga HM, Langendijk JA, Weijs PJ, et al. Critical weight loss is a major prognostic indicator for disease-specific survival in patients with head and neck cancer receiving radiotherapy. Br J Cancer. 2013;109(5):1093-9.
Hébuterne X, Lemarié E, Michallet M, de Montreuil CB, Schneider SM, Goldwasser F. Prevalence of malnutrition and current use of nutrition support in patients with cancer. JPEN J Parenter Enteral Nutr. 2014;38(2):196-204.
Loh KW, Vriens MR, Gerritsen A, Borel Rinkes IHM, Van Hillegersberg R, Schippers C, et al. Unintentional weight loss is the most important indicator of malnutrition among surgical cancer patients. Nithreland J Med. 2012; 335:365-9.
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