Helena Orell-Kotikangas1, Pia Österlund2, Outi Mäkitie3, Kauko Saarilahti2, Paula Ravasco4, Ursula Schwab5,6, Antti A Mäkitie7,8. 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).
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).
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