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Malnutrition, cancer stage and gastrostomy timing as markers of poor outcomes in gastrostomy-fed head and neck cancer patients

datacite.subject.fosCiências Médicas
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorSousa-Catita, Diogo
dc.contributor.authorFerreira-Santos, Cláudia
dc.contributor.authorMascarenhas, Paulo
dc.contributor.authorOliveira, Cátia
dc.contributor.authorMadeira, Raquel
dc.contributor.authorSantos, Carla Adriana
dc.contributor.authorAndré, Carla
dc.contributor.authorGodinho, Catarina
dc.contributor.authorAntunes, Luís
dc.contributor.authorFonseca, Jorge
dc.date.accessioned2026-03-05T16:16:24Z
dc.date.available2026-03-05T16:16:24Z
dc.date.issued2023-02
dc.description.abstractFor percutaneous endoscopic gastrostomy (PEG)-fed head and neck cancer (HNC) patients, risk markers of poor outcomes may identify those needing more intensive support. This retrospective study aimed to evaluate markers of poor outcomes using TNM-defined stages, initial anthropometry [body mass index (BMI), mid-upper arm circumference (MUAC), tricipital skinfold (TSF), mid-arm muscle circumference (MAMC)] and laboratory data (albumin, transferrin, cholesterol), with 138 patients, 42–94 years old, enrolled. The patients had cancer, most frequently in the larynx (n = 52), predominantly stage IV (n = 109). Stage IVc presented a four times greater death risk than stage I (OR 3.998). Most patients presented low parameters: low BMI (n = 76), MUAC (n = 114), TSF (n = 58), MAMC (n = 81), albumin (n = 47), transferrin (n = 93), and cholesterol (n = 53). In stages I, III, IVa, and IVb, MAMC and PEG-timing were major survival determinants. Each MAMC unit increase resulted in 16% death risk decrease. Additional 10 PEG-feeding days resulted in 1% mortality decrease. Comparing IVa/IVb vs. IVc, albumin and transferrin presented significant differences (p = 0.042; p = 0.008). All parameters decreased as severity of stages increased. HNC patients were malnourished before PEG, with advanced cancer stages, and poor outcomes. Initial MAMC, reflecting lean tissue, significantly increases survival time, highlighting the importance of preserving muscle mass. PEG duration correlated positively with increased survival, lowering death risk by 1% for every additional 10 PEG-feeding days, signaling the need for early gastrostomy.eng
dc.identifier.citationSousa-Catita D, Ferreira-Santos C, Mascarenhas P, Oliveira C, Madeira R, Santos CA, André C, Godinho C, Antunes L, Fonseca J. Malnutrition, Cancer Stage and Gastrostomy Timing as Markers of Poor Outcomes in Gastrostomy-Fed Head and Neck Cancer Patients. Nutrients. 2023; 15(3):662. https://doi.org/10.3390/nu15030662
dc.identifier.doi10.3390/nu15030662
dc.identifier.issn2072-6643
dc.identifier.urihttp://hdl.handle.net/10400.26/61991
dc.language.isoeng
dc.peerreviewedyes
dc.publisherMDPI
dc.relation.hasversionhttps://doi.org/10.3390/nu15030662
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjecthead and neck cancer
dc.subjectnutritional status
dc.subjectpercutaneous endoscopic gastrostomy
dc.titleMalnutrition, cancer stage and gastrostomy timing as markers of poor outcomes in gastrostomy-fed head and neck cancer patientseng
dc.typecontribution to journal
dspace.entity.typePublication
oaire.citation.issue3
oaire.citation.startPage662
oaire.citation.titleNutrients
oaire.citation.volume15
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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