Impact of Nutritional Status on Survival in Head and Neck Cancer Patients After Total Laryngectomy.

Malnutrition is an important prognostic indicator of laryngeal squamous cell carcinoma. Retrospective study with head and neck cancer patients who underwent total laryngectomy. 243 patients of both sex were evaluated. The univariate analyses demonstrated an increased risk of death for the patients with greater weight loss, hypoalbuminemia, radiotherapy as an initial treatment, salvage surgery, and radical neck dissection. In a Multivariate Cox regression, older age (p = 0.03, 95% confidence interval [CI] 1.003-1.06, hazard ratio [HR] 1.029), Nutritional Risk Index ≤100 (p = 0.008, 95% CI 1.18-3.12, HR 1.921) and adjuvant radiotherapy (p = 0.029, 95% CI 0.31-3.12, HR 0.544) demonstrated prognostic significance in survival. Nutritional status is a modifiable variable and these findings highlight the need to adoption of simple nutritional assessment methods routinely during the treatment of head and neck cancer patients, in order to help improve prognosis after surgery.

Influence of nutritional status and frailty phenotype on health-related quality of life of patients with bladder or kidney cancer.

PURPOSE: This research aimed to assess the impact of nutritional status and frailty in the health-related quality of life (HRQoL) of patients with bladder or kidney cancer. METHODS: This was a cross-sectional study with individuals aged 20 years or older. Frailty phenotype was defined using the criteria of Fried et al. (2001). Patient-Generated Subjective Global Assessment (PG-SGA) classified nutritional status. The European Organization for Research and Treatment of Cancer Quality of life questionnaire Core-30 third version (EORTC QLQ-C30) assessed HRQoL. RESULTS: Forty-four patients with bladder and 44 with kidney cancer, mostly male, with a mean age of 65.9 and 58.6 years, respectively, were evaluated. Presence of frailty was not different between young and older adults. More than 80% of the robust subjects were well-nourished, while there was a predominance of frail with some degree of malnutrition (p < 0.05). The summary score of HRQoL was worse among the frails than pre-frails and robusts, both in bladder (68.5 vs 86.8 vs 89.5; p = 0.002) and in kidney cancer (54.9 vs 82.9 vs 91.4; p < 0.001), as well as in malnourished compared to well-nourished with bladder (72.9 vs 90.3; p = 0.003) and kidney cancer (69.4 vs 88.3; p = 0.001). After adjusted, frailty and malnutrition continued associated with poor summary score (p < 0.05). CONCLUSION: These findings indicate that frailty and malnutrition negatively affect HRQoL of patients with bladder or kidney cancer in several aspects.

Factors influencing health-related quality of life in patients with bladder or kidney cancer: a prospective cohort study of the impact of nutritional status and frailty phenotype.

PURPOSE: This study aimed to investigate the impact of nutritional status and frailty phenotype and the predictors of temporal changes on health-related quality of life (HRQoL) of patients with bladder or kidney cancer. METHODS: Frailty phenotype, Patient-Generated Subjective Global Assessment, and Quality-of-life questionnaire Core-30 were applied twice to patients diagnosed with bladder or kidney cancer. Patients also completed a sociodemographic questionnaire, and clinical data were collected from records. RESULTS: Sixty-two individuals completed the study, mostly male, with a mean age of 62.5 (± 11.4) years. The median time of follow-up was 14.5 months. Role functioning, emotional functioning, and fatigue improved over time (p < 0.05). The factors that negatively affected the long-term quality of life summary score were being female, malnourished, pre-frail and frail, cancer treatment, performance status, and lower income. Using the multivariate model, being malnourished (ß = - 7.25; 95% CI, - 10.78 to - 3.71; p < 0.001), frail (ß = - 7.25; 95% CI, - 13.39 to - 1.11; p = 0.021), and each one-point increase in performance status (ß = - 6.9; 95% CI, - 9.54 to - 4.26; p < 0.001), were the ones that most negatively impacted the HRQoL between the two assessments. CONCLUSION: This study confirmed that frailty, nutritional status, and performance status are the main predictors of HRQoL of patients with bladder or kidney cancer over time. IMPLICATIONS FOR CANCER SURVIVORS: These findings may be the first step towards highlighting the importance of preventing malnutrition and frailty, in favor of a better long-term QoL for cancer patients.