Nutritional conditions in oral squamous cell carcinoma patients -prospective longitudinal observational study

BACKGROUND: Cancer-related malnutrition is an often-disregarded problem with a lack of knowledge and standards concerning diagnosis and therapy. Patients with oral squamous cell cancer can suffer not only from metabolic factors but also from aggravated oral food intake. This study examines the issue of malnutrition in patients with oral squamous cell carcinoma (OSCC) before diagnosis and under treatment. METHODS: The nutritional status of 30 patients with OSCC was registered before and after surgical treatment, with a time interval of 16 weeks. The methods applied were body mass index (BMI), subjective global assessment (SGA) and bioelectrical impedance analysis (BIA). The reference group consisted of 30 patients planned for orthognathic surgery. Equal for both groups were postoperative nasogastric tube feeding. The data for the OSCC patients were analysed and tested for significance at the level of p = 0.05. RESULTS: Preoperative malnutrition, as expected, was only detected in the OSCC group. Only 6% of OSCC patients start with a good nutritional status, but this increases to nearly 50% during therapy, although two patients ended up with severe malnutrition. Nonetheless, 40% of the reference group were malnourished after the first week, according to the SGA. The nutritional status improved during therapy to a good status in nearly all cases. CONCLUSION: Malnutrition is a relevant problem in patients with OSCC due to the high prevalence in this population, which was confirmed by these data. Appropriate diagnostic tools and an adapted treatment concept in terms of application form and ingredients, as well as supplements, should be an integral part of the treatment concept for these patients. Additionally, the data from these studies recommend that patients who are preoperatively healthy and have temporary postoperative restrictions on oral food intake be provided with an adequate nutrient supply. An important component of nutritional interventions should be the long-term prevention of skeletal muscle loss.