Application of bioelectrical impedance analysis in monitoring patients with head and neck cancer after surgical intervention.

Introduction: It is estimated that about 60% of patients with head and neck cancer (HNC) show poor nutritional status, and approximately 80% lose weight during treatment. The impact of surgical procedures on the risk of further weight loss, severe malnutrition and cachexia is a significant clinical problem that determines the higher incidence of postoperative complications, reduced effectiveness of the treatment used, longer hospitalization time, poor quality of life and higher mortality among patients. Bioelectrical impedance analysis (BIA) is currently recognized as a useful method of assessing the body composition and therefore the nutritional status of cancer patients. The aim of this study is to investigate whether measured and calculated parameters of BIA change shortly after surgery and could reflect the health of cells and body composition changes.

Materials and methods: We enrolled 54 patients (males) with advanced HNC in this observational study. We collected detailed anthropometric and BIA derived data. The Subjective Global Assessment (SGA) was used to assess the nutrition.

Results: In the assessment performed one week after the surgery, compared to the condition on the day of surgery, the patients had significantly lower values of nutritional status (weight; body mass index - BMI; SGA), body composition (free fat mass - FFM; intracellular fluid - ICF; total body water - TBW). Other changes include a significant increase in fat mass (FM) or extracellular fluid (ECF). Moreover, a significant reduction of phase angle (PA, one of the most important BIA derived prognostic factors) was also noted.

Conclusions: Apart from the baseline assessment of the body composition and diagnosing nutritional disorders, it seems, that BIA should be considered also in the monitoring of HNC patients undergoing surgery.