Cachexia at diagnosis is associated with poor survival in head and neck cancer patients

To evaluate the use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. An observational study assessing the nutritional status of patients with cancer. Oncology ward of a private tertiary Australian hospital. Seventy-one cancer patients aged 18-92 y. Scored PG-SGA questionnaire, comparison of scored PG-SGA with subjective global assessment (SGA), sensitivity, specificity. Some 24% (17) of 71 patients were well nourished, 59% (42) of patients were moderately or suspected of being malnourished and 17% (12) of patients were severely malnourished according to subjective global assessment (SGA). The PG-SGA score had a sensitivity of 98% and a specificity of 82% at predicting SGA classification. There was a significant difference in the median PG-SGA scores for each of the SGA classifications (P<0.001), with the severely malnourished patients having the highest scores. Re-admission within 30 days of discharge was significantly different between SGA groups (P=0.037). The mortality rate within 30 days of discharge was not significantly different between SGA groups (P=0.305). The median length of stay of well nourished patients (SGA A) was significantly lower than that of the malnourished (SGA B+C) patients (P=0.024). The scored PG-SGA is an easy to use nutrition assessment tool that allows quick identification and prioritisation of malnutrition in hospitalised patients with cancer.

Major weight loss is common in patients with head and neck squamous cell carcinoma (HNSCC) who undergo radiotherapy (RT). How baseline and posttreatment body composition affects outcome is unknown.

Critical weight loss (> or =5% in 1 month or > or =10% in 6 months) is a common phenomenon in head and neck cancer patients. It is unknown which complaints are most strongly related to critical weight loss in head and neck cancer patients at the time of diagnosis. The aim of this explorative study was to assess the prevalence of critical weight loss and to analyze risk factors for critical weight loss in head and neck cancer patients before treatment. Critical weight loss and factors reducing dietary intake were assessed in 447 patients referred to an ear, nose and throat clinic at the time of diagnosis. In total, data of 407 patients were analyzed. Critical weight loss was present in 19% of the patients. Patients with cancer in the hypopharynx, oropharynx/oral cavity and supraglottic larynx had the highest risk for critical weight loss. Loss of appetite, dysphagia/passage difficulties and loss of taste/aversion were significantly (p < 0.05) associated with critical weight loss. Already before treatment, critical weight loss is a considerable problem in head and neck cancer patients. Critical weight loss is frequently observed in patients with cancer in the hypopharynx, oropharynx/oral cavity and supraglottic larynx.