Department of Cranio-Maxillofacial Surgery, Military Institute of Medicine - National Research Institute, Warsaw, Poland.
Department of Otolaryngology and Oncology, Military Institute of Medicine - National Research Institute, Warsaw, Poland.
Nutr Cancer. 2023;75(9):1803-1810. doi: 10.1080/01635581.2023.2242105. Epub 2023 Aug 4.
This study aimed to assess clinical factors that could predict the need for nasogastric feeding after surgery in patients with head and neck cancer (HNC) and evaluate the effect of tube feeding on selected laboratory parameters.This single-center retrospective study included 153 patients who underwent surgery for HNC. Data on patient and tumor characteristics were collected, along with laboratory measurements. Logistic regression was used to identify the predictors of the need for nasogastric feeding. Laboratory parameters were compared between patients who required nasogastric feeding vs those who did not.Nasogastric feeding was required in 90 patients (59%). Significant predictors of nasogastric feeding in HNC patients after surgery, which were revealed by univariate regression analysis, included low body mass index (odds ratio [OR] = 0.84), squamous cell carcinoma histology (OR = 8.05), T2 tumor stage (OR = 2.27), red blood cell count (M/µL) (OR = 0.44), hemoglobin levels (g/dL) (OR = 0.80), and mean corpuscular volume (fL) (OR = 1.10). Multivariate analysis showed that low BMI (OR = 0.87) and red blood cell count (M/µL) (OR = 0.32) were prognostic factors for nasogastric feeding. A significant percentage increase in white blood cell count from admission to discharge was noted in patients who required nasogastric feeding vs those who did not ( = 0.003).Determining factors that predict the need for nasogastric feeding in HNC patients after surgery may support more personalized treatment planning to optimize clinical outcomes.
本研究旨在评估预测头颈部癌症(HNC)患者手术后需要鼻胃管喂养的临床因素,并评估管饲对选定实验室参数的影响。这项单中心回顾性研究纳入了 153 例接受 HNC 手术的患者。收集了患者和肿瘤特征数据以及实验室测量值。使用逻辑回归来确定需要鼻胃管喂养的预测因素。比较了需要鼻胃管喂养的患者和不需要鼻胃管喂养的患者的实验室参数。90 例(59%)患者需要鼻胃管喂养。单因素回归分析显示,HNC 患者手术后需要鼻胃管喂养的显著预测因素包括低体重指数(比值比[OR] = 0.84)、鳞状细胞癌组织学(OR = 8.05)、T2 肿瘤分期(OR = 2.27)、红细胞计数(M/µL)(OR = 0.44)、血红蛋白水平(g/dL)(OR = 0.80)和平均红细胞体积(fL)(OR = 1.10)。多因素分析显示,低体重指数(OR = 0.87)和红细胞计数(M/µL)(OR = 0.32)是鼻胃管喂养的预后因素。需要鼻胃管喂养的患者与不需要鼻胃管喂养的患者相比,从入院到出院的白细胞计数显著增加( = 0.003)。确定 HNC 患者手术后需要鼻胃管喂养的因素可能有助于支持更个性化的治疗计划,以优化临床结果。