PD881 - CLINICAL PRACTICE AND NUTRITIONAL SUPPORT IN HEAD AND NECK CANCER: A NORDIC PERSPECTIVE

PD881

CLINICAL PRACTICE AND NUTRITIONAL SUPPORT IN HEAD AND NECK CANCER: A NORDIC PERSPECTIVE

D. D. Solli¹, K. Jontell^2,*, A. Erichsen³, M. Erichsen⁴, R. Kumar⁵, C. Staxen⁶, S. Mikkelsen⁷, Ø. Irtun⁸, M. Holst^7,9

¹Medical Department, St Göran's Hospital, Stockholm, ²Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden, ³Department of Clinical Nutrition, Gødstrup Hospital, Gødstrup, Denmark, ⁴Department of Clinical Medicine, Metabolism and Clinical Nutrition Research Group, UiT, The Arctic University of Norway, Tromsø, ⁵NutriConsult, c/o Epicenter, 0166 Oslo, Norway, ⁶Department of Hematology, Zealand University Hospital, Roskilde, ⁷Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark, ⁸Department of Clinical Medicine, UiT, The Arctic University of Norway, Tromsø, Norway, ⁹Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark

Rationale: Malnutrition is prevalent and associated with poor outcomes for patients with head and neck cancer (HNC). This study aimed to explore nutritional care practices for HNC according to national and international guidelines in Denmark (DK), Finland (FI), Norway (NO), and Sweden (SE).

Methods: Questionnaires based on established guidelines were developed - one focusing of radiotherapy (RT) and one on surgery (SR) - and distributed to a physician, a clinical dietitian (CD), and a nurse or radiotherapist at each participating university hospital unit. Descriptive statistics and Chi2 were used for comparison of categorical data.  

Results: Response rate was 60%, with 45 respondents for RT and 38 for SR. Respondents were 33%, 18%, 21% and 28% for DK, FI, NO and SE, respectively.

At the first appointment the majority weighed patients (96% RT, 81% SR), and identified unplanned weight loss (98% RT, 92% SR, p=0.235), while routine nutritional screening was performed in 62% (60% RT, 64% SR, p=0.758).

At multidisciplinary conferences, (MDC) (n=66) nutritional status was discussed in 28% of cases (21% RT, 35% SR), most frequently in DK (38%; SE 29%; FI 29%; NO 14%; p=0.508). A CD participated in 21% of MDCs, most often in FI (40%; SE 26%; DK 9%; NO 6%; p=0.037). Enteral nutrition was the firsthand option when oral intake was insufficient (n=77). Prophylactic enteral tube placement was more common in SR (91%) than in RT (55%) (p<0.001).

Malnutrition diagnosis according to the GLIM criteria was more frequent in SE (63%), compared with NO (50%), DK (30%) and FI (7%) (p=0.007), with no difference between RT and SR.

Conclusion: Procedures for early screening, diagnosis and treatment of malnutrition vary across countries. While routines for weighing patients are well established, nutritional screening is performed less consistently. Nutrition is not yet fully integrated into the MDC, indicating a potential area for improvement. 

Disclosure of Interest: None declared