Assessment of nutritional risk in patients with head-and-neck cancer at the time point of tumor diagnosis

Background Malnutrition in patients with head-and-neck cancer results in a high risk of mortality, prolonged length of hospital stay as well as in a loss of quality of life. The Nutritional Risk Screening (NRS) is a simple validated tool for the nutrition assessment. Aim of the study presented here was to evaluate the nutritional risk of head-and-neck cancer patients (HNC) at the time point of tumor diagnosis, that is, before the onset of the oncological therapy and to detect possible influence factors.

Material and Methods The NRS was conducted from 2015 - 2019 on 88 HNC patients. (1) Tumor localisation, (2) UICC stage, (3) age, and (4) sex were documented as possible influence factors. During FEES^® evaluation, (5) penetration / aspiration (PAS), (6) grade of oralisation (FOIS), and (7) care relevant swallowing disorders (VRS) were determined.

Associations between NRS total score and possible influence factors were examined by Spearman’s correlations, Kruskal-Wallis H- und Mann-Whitney U-tests.

Results A total of 33 % of patients in our sample showed an increased risk of nutritional status before the therapy onset. NRS total score correlated significantly with patients’ age (ρ = 0,403, p < 0,001), FOIS (ρ = -0,460, p < 0,001), and VRS (ρ = 0,345, p = 0,001). No significant associations were found with UICC stage and PAS as well as with sex and tumor localisation.

Discussion One third of HNC patients underlie a high nutritional risk before the onset of the oncological therapy. A systematic evaluation of this risk in the HNC population should be conducted before oncological therapy starts to develop an individual nutrition plan and to avoid secondary complications.

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Publication History

Article published online:
10 June 2020