Teresa E Brown1,2, Kym Wittholz2, Mandy Way3, Merrilyn D Banks1, Brett G M Hughes4,5, Charles Y Lin4, Lizbeth M Kenny4, Judith D Bauer2. 1. Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Queensland, Australia. 2. Centre for Dietetic Research (C-DIET-R), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia. 3. QIMR, Berghofer Medical Research Institute, Herston, Queensland, Australia. 4. Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. 5. School of Medicine, University of Queensland, Queensland, Australia.
Abstract
BACKGROUND: The purpose of this study was to determine if p16 status, chemotherapy regimen, or other nutrition markers could improve protocol accuracy in predicting proactive gastrostomy in patients with head and neck cancer. METHODS: Patients who received curative treatment from July 2010 to June 2011 were included (n = 269). Associations among dependent variables (age, sex, tumor site, staging, treatment, p16 status, albumin, and Malnutrition Screening Tool [MST] score), the protocol risk rating, and requirement for proactive gastrostomy were examined. RESULTS: Current protocol correctly identified 81 of 88 high-risk patients (92%) for gastrostomy, but incorrectly classified 32 of 181 low-risk patients (18%). Analysis of low-risk patients with oral or oropharyngeal cancers, found p16-positive disease had 4.4 times greater odds (p = .049), and those at risk of malnutrition had 4.5 times greater odds (p = .019) of requiring gastrostomy. CONCLUSION: Malnutrition risk and p16 status could be used to identify further patients who may benefit from proactive gastrostomy.
BACKGROUND: The purpose of this study was to determine if p16 status, chemotherapy regimen, or other nutrition markers could improve protocol accuracy in predicting proactive gastrostomy in patients with head and neck cancer. METHODS:Patients who received curative treatment from July 2010 to June 2011 were included (n = 269). Associations among dependent variables (age, sex, tumor site, staging, treatment, p16 status, albumin, and Malnutrition Screening Tool [MST] score), the protocol risk rating, and requirement for proactive gastrostomy were examined. RESULTS: Current protocol correctly identified 81 of 88 high-risk patients (92%) for gastrostomy, but incorrectly classified 32 of 181 low-risk patients (18%). Analysis of low-risk patients with oral or oropharyngeal cancers, found p16-positive disease had 4.4 times greater odds (p = .049), and those at risk of malnutrition had 4.5 times greater odds (p = .019) of requiring gastrostomy. CONCLUSION: Malnutrition risk and p16 status could be used to identify further patients who may benefit from proactive gastrostomy.