Pattern of Nutritional status in Node Negative versus Node Positive Head and Neck Cancer patients undergoing treatment - a prospective cohort study

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, during and after treatment. Statistical analysis was performed using SPSS version 22. Data was analyzed using parametric and non-parametric tests, p value of 0.05 was considered significant. Results 161 patients were analyses, 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 40.8–52.5% overall, 20.5–41.1% N0, 39.5–62.8% N+. Mean reduction in weight (11.1% ±7.82 v/s 6.26% ±8.3, p=0.000), mean reduction in BMI (2.57 ±1.87 v/s 1.29 ±1.62, p=0.000), median reduction in MUAC (2cm v/s 1cm, p=0.000) and median increase in SGA score were higher (13 v/s 6, p=0.000) in multi-modality as compared to 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, 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.