LB105 - COMPLEX NUTRITIONAL SCREENING IN PATIENTS WITH LOCALLY ADVANCED HEAD AND NECK CANCER: THE ROLE OF FUNCTIONAL AND ANTHROPOMETRIC PARAMETERS IN CLINICAL STRATIFICATION

LB105

COMPLEX NUTRITIONAL SCREENING IN PATIENTS WITH LOCALLY ADVANCED HEAD AND NECK CANCER: THE ROLE OF FUNCTIONAL AND ANTHROPOMETRIC PARAMETERS IN CLINICAL STRATIFICATION

M. Jedlička^1,*, K. Licková², T. Šulc¹, M. Chovanec¹

¹Department of Otorhinolaryngology, ²Department of Oncology, University Hospital Královské Vinohrady, Prague, Czech Republic

Rationale: Patients diagnosed with locally advanced head and neck squamous cell carcinoma (HNSCC) frequently present with malnutrition and sarcopenia at the time of diagnosis. These conditions are associated with significant metabolic stress, obstructive symptoms, and inflammatory activation, all of which negatively impact the efficacy of oncologic treatment, increase treatment-related toxicity, and reduce overall survival. The Body Mass Index (BMI), although commonly used as a nutritional status indicator, lacks sensitivity in detecting loss of active muscle mass. This prospective study aimed to assess the nutritional status of HNSCC patients prior to treatment initiation using a combination of anthropometric, functional, and body composition parameters, and to identify clinically relevant cases of subclinical malnutrition.

Methods: Between February and June 2025, patients with newly diagnosed, histologically confirmed locally advanced HNSCC were evaluated at the University Hospital Královské Vinohrady. The complex nutritional screening included BMI measurement, assessment of upper limb muscle strength using handgrip dynamometry, and body composition analysis—specifically lean body mass (LBM), skeletal muscle mass, and other related metrics. These parameters were analysed in the context of demographic and clinical data (age, sex, tumour localization).

Results: A total of 31 patients were included in the analysis (83.88% male, 16.12% female), with a mean age of 66.03 years (SD 10.64). The most common tumour site was the oral cavity (38.71%), followed by the oropharynx and larynx (each 22.58%), and cervical lymph node metastases of unknown primary origin (16.12%). The mean BMI was 24.24 (SD 5.22), mean handgrip strength was 26.17 kg (SD 8.12), and mean lean body mass was 52.87 kg (SD 7.71). More than one-third of patients exhibited signs of muscle wasting and reduced functional capacity despite having a normal BMI, consistent with the phenomenon of “hidden sarcopenia.”

Conclusion: Our findings confirm that BMI alone is insufficient for detecting nutritional deficits in oncology patients with HNSCC. The inclusion of handgrip dynamometry and quantitative body composition analysis significantly enhances the sensitivity of nutritional screening and enables early identification of functional sarcopenia or preclinical malnutrition. These parameters should be integrated into baseline oncologic assessments to identify patients who may benefit from early nutritional intervention. Incorporating advanced nutritional screening into standard treatment protocols has the potential to improve treatment tolerance, reduce complication rates, and positively influence clinical outcomes.

References: Tomkinson GR, Lang JJ, Rubin L, et al. International norms for adult handgrip strength: A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions. J Sport Health Sci. 2024 Dec 6; 14:101014. Amaral MA, Mundstock E, Scarpatto CH, et al. Reference percentiles for bioimpedance body composition parameters of healthy individuals: A cross-sectional study. Clinics (Sao Paulo). 2022 Sep 7; 77:100078.

Disclosure of Interest: None declared