Patterns of nutritional deficiency in head and neck cancer

A nutritional assessment battery consisting of anthropometric measurements, skin tests, laboratory assessment of visceral and somatic proteins, and a questionnaire was used to characterize the nutritional status of 50 consecutive new head and neck tumor patients. Forty percent of our patients had good nutrition, 20% fair, and 40% poor, with elements of both protein-calorie and protein malnutrition. There was, as expected, a positive relationship between tumor stage and nutritional impairment, but this fell short of statistical significance. There was a just significant tendency for patients with pharyngeal tumors to exhibit poorer scores than did those with oral or laryngeal tumors. Age, sex, smoking history, admitted alcohol consumption, and type of hospital (university, private multispecialty, or Veterans Administration) were not correlated with nutritional status. The best predictor of impaired nutritional status was the patient's description of his recent diet: a normal diet predicted a good score (0–2), and a soft or liquid diet predicted a fair or poor score (3–5), with an overall accuracy of 72%.