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

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).

Keywords:

• Nutritional status
• handgrip strength
• anthropometry
• oncology

Acknowledgments

The study was financially supported by the Finnish Cultural Foundation, the Helsinki University Hospital Research Funds, and the Swedish Childhood Cancer Foundation.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This study was financially supported by grants from the Finnish Cultural Foundation, the Helsinki University Hospital Research Funds, Helsinki, Finland and the Swedish Childhood Cancer Foundation. The study sponsors did not have any involvement in the study design, data collection, analysis and interpretation of data, the writing of the manuscript, and in the decision to submit the manuscript for publication.