Abstract
Objective: Malnutrition is common among head and neck cancer patients and it impacts survival and quality of life. This study aims to identify predictors of malnutrition at time of diagnosis in order to enable early nutritional support and prevent malnutrition in patients at risk.
Method: A total of 134 patients with advanced oral and pharyngeal cancer were included in the study. Weight, body mass index (BMI), fat-free mass (FFM), dysphagia, and quality of life were measured at diagnosis and after 6 months. Two definitions for malnutrition were applied: >10% weight loss and BMI <20 after 6 months.
Results: Six months after diagnosis, 66% of the patients were malnourished, applying >10% weightloss definition and 26% applying BMI <20. In multivariate analysis, chemotherapy and high BMI at diagnosis were the strongest predictors of malnutrition, using 10% weight loss definition and low BMI followed by low FFM and dysphagia were the strongest predictors using BMI <20.
Conclusion: Inconsistent predictors were found depending on the definition used for defining malnutrition. Unintended weight loss of more than 10% seems to be the most reasonable definition for malnutrition since this also correlated to a significant loss of FFM, consequently pointing out treatment with chemoradiotherapy as the strongest predictor for malnutrition.
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