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Pattern of nutritional status in node-negative versus node-positive head and neck cancer patients undergoing treatment: a prospective cohort study

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Abstract

Purpose

The aim of this study was to study the nutritional profile of node-negative and node-positive patients undergoing treatment for head and neck squamous cell cancer (HNSCC).

Methods

This prospective cohort study was conducted between 2018 and 2020. Patients diagnosed with HNSCC, planned for treatment, were enrolled after written informed consent. In node-negative (N0) and node-positive (N +) cohorts of patients, nutritional status was determined using anthropometric measures and Subjective Global Assessment (SGA) scale pre-treatment, and during and after treatment. Statistical analysis was performed using SPSS version 22. Data was analyzed using parametric and non-parametric tests, and p value of 0.05 was considered significant.

Results

In total, 161 patients were analyzed, 73 N0 and 88 N + cohorts. Pre-treatment, 9.6 to 20.4% patients in N0 and 23.9 to 32.8% patients in N + cohorts were malnourished. Incidence of malnutrition at completion of treatment was 40.8 to 52.5% overall, 20.5 to 41.1% N0, and 39.5 to 62.8% N + . Mean reduction in weight (11.1% ± 7.82 vs 6.26% ± 8.3, p = 0.000), mean reduction in BMI (2.57 ± 1.87 vs 1.29 ± 1.62, p = 0.000), median reduction in MUAC (2 cm vs 1 cm, p = 0.000), and median increase in SGA score (13 vs 6, p = 0.000) were higher in multi-modality as compared to those in a single-modality treatment. Similar findings were noted in N0 and N + cohorts.

Conclusion

As compared to N0, N + patients had higher burden of malnutrition at diagnosis, and more worsening of nutritional parameters during treatment. More decline in nutritional status was seen in patients receiving multi-modality as compared to single-modality treatment.

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Data availability

Available.

Code availability

SPSS version 22.

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Authors and Affiliations

  1. Department of Surgical Oncology, Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India

    Sunil Saini

  2. Department of Radiation Oncology, Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India

    Meenu Gupta

  3. Department of Oncological Sciences, Associate Professor, Department of Surgical Oncology, Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India

    Anshika Arora

Authors
  1. Anshika Arora
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  2. Sunil Saini
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Contributions

All the authors contributed to the study conception and design. Material preparation, and data collection and analysis were performed by Anshika Arora, Sunil Saini, and Meenu Gupta. The first draft of the manuscript was written by Anshika Arora and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Sunil Saini.

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Ethics committee approval number: SRHU/HIMS/ETHICS/2018/115.

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A written informed consent was obtained from all participants.

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Consent for publication was obtained from the Institutional Research Committee.

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The authors declare no competing interests.

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Arora, A., Saini, S. & Gupta, M. Pattern of nutritional status in node-negative versus node-positive head and neck cancer patients undergoing treatment: a prospective cohort study. Support Care Cancer 30, 8029–8039 (2022). https://doi.org/10.1007/s00520-022-07245-6

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  • DOI: https://doi.org/10.1007/s00520-022-07245-6

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