[Assessment of the relevance of diagnostic tools for undernutrition in patients with head and neck cancers].

Abstract

Introduction: Malnutrition is a major prognostic factor in head and neck cancers. The French National Authority for Health recommends several methods for diagnosing malnutrition. The main aim of this study was to determine whether the methods used to diagnose malnutrition prior to any treatment by the dietician, the adapted physical activity teacher and impedancemetry were complementary or redundant.

Method: Sixty-six patients aged 18 to 70 with head and neck cancer who had undergone nutritional assessment using the three methods prior to cancer treatment were retrospectively included. The mean age was 54.9 years. The most frequent location was oropharyngeal cancer.

Results: Thirty-four patients were malnourished at the time of diagnosis of their head and neck cancer according to at least one of the tests (52.3%). The specificities of the different tests used ranged from 3.3 to 55.2%, and those of each method (diet, adapted physical activity and impedancemetry) from 48.4 to 64.7%. The diagnosis of malnutrition by two of the three methods was concordant in 26.1% to 38.5% of cases, and by all three methods in 2.9% of cases of malnutrition (the diagnosis of malnutrition was made by all three methods in a single patient).

Conclusion: The combined use of assessment by a dietician, an adapted physical activity teacher and impedancemetry offers a more complete, complementary and non-redundant approach to the diagnosis of malnutrition in patients with head and neck cancer, which can probably be generalised to all patients with solid or haematological cancer.