Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, 01-445 Warsaw, Poland.
Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, 00-581 Warsaw, Poland.
Nutrients. 2022 Mar 17;14(6):1268. doi: 10.3390/nu14061268.
Malnutrition is a poor prognostic factor in cancer disease. In case of head and neck cancer, there are multiple disease symptoms and side effects of treatment that increase the risk of malnutrition. The aim of the study is to assess the association between nutritional status at the time of qualification for home enteral nutrition (HEN) and overall survival of patients with head and neck cancer (HNC), and assessment usefulness of selected nutritional indices as prognostic factors. The retrospective survival analysis involved 157 patients with HNC referred to HEN between January 2018 and October 2021. The nutritional status assessment was performed at the qualification for HEN visit. We have analyzed results of body mass index (BMI), Nutritional Risk Index (NRI) for patients <65 years, Geriatric Nutritional Risk Index (GNRI) for patients ≥65 years and malnutrition defined by Global Leadership Initiative on Malnutrition (GLIM). The mean patient survival was 44.7 weeks and the median was 23.9 weeks. Patients with low NRI and GNRI score had a higher risk of death (NRI: p = 0.0229; GNRI: p = 0.371). NRI, GNRI, and malnutrition defined by GLIM were superior to BMI as prognostic markers for survival. Results suggest that the use of NRI, GNRI, and GLIM criteria could provide useful prognostic information. The longer survival since the qualifying visit for home enteral nutrition suggests that nutritional management could be initiated earlier.
营养不良是癌症疾病的一个不良预后因素。在头颈部癌症的情况下，存在多种疾病症状和治疗副作用，增加了营养不良的风险。本研究旨在评估头颈部癌症（HNC）患者在接受家庭肠内营养（HEN）资格时的营养状况与总生存之间的关联，并评估选定的营养指标作为预后因素的评估效用。这项回顾性生存分析涉及了 157 名于 2018 年 1 月至 2021 年 10 月期间被转介至 HEN 的 HNC 患者。在接受 HEN 的资格审查访视时进行了营养状况评估。我们分析了<65 岁患者的体重指数（BMI）、NRI、≥65 岁患者的 GNRI 和 GLIM 定义的营养不良的结果。患者的平均生存时间为 44.7 周，中位数为 23.9 周。NRI 和 GNRI 评分较低的患者死亡风险更高（NRI：p=0.0229；GNRI：p=0.371）。NRI、GNRI 和 GLIM 定义的营养不良比 BMI 作为生存的预后标志物更优。结果表明，使用 NRI、GNRI 和 GLIM 标准可以提供有用的预后信息。从资格审查访视到接受家庭肠内营养的时间越长，提示营养管理可能更早开始。
