Bioelectrical phase angle at diagnosis as a prognostic factor for survival in advanced head and neck cancer

Lars Axelsson,Ingvar Bosaeus,Ewa Silander,Eva Hammerlid

doi:10.1007/s00405-018-5069-2

Lars Axelsson, Ingvar Bosaeus + Show 2 more

Open Access

https://doi.org/10.1007/s00405-018-5069-2

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Abstract

ObjectiveBioelectrical impedance analysis (BIA) is used to measure the patient’s body composition, fat-free mass, phase angle (PA), and standardized phase angle (SPA), which are affected by malnutrition. Low values of PA and SPA have been found to be negative prognostic factors for survival in different types of cancer and other severe diseases. The aim of the current study was to investigate whether PA and SPA can be used to predict survival in head and neck (HN) cancer.MethodsOne hundred twenty-eight patients with advanced HN cancer treated in Western Sweden 2002–2006 were examined with BIA at diagnosis, and PA and SPA were calculated. Patients’ age, gender, tumor site, TNM stage, and performance status were obtained, and weight, height, and BIA were measured. Survival up to 12 years was ascertained.ResultsThe mean PA was 5.85° and the median was 5.91°. Lower PA and SPA values were significantly associated with shorter overall survival in univariate analyses, together with higher age, oral cancer, higher T class, worse performance status, more weight loss before diagnosis, lower: weight, height, BMI, and reactance. Age, performance status, T class, and PA were significant factors for the overall survival in the multivariable analysis. A PA cutoff value at 5.95° provided the best prediction of 5-year survival.ConclusionsPA and SPA at diagnosis are significant factors for survival in patients with advanced HN cancer. They are promising prognostic tools to use in treatment planning; further studies are needed.

Highlights

Head and neck (HN) cancer constitutes approximately 4% of all cancer in Western countries and is more common in developing countries [1]
The study population consisted of 128 patients with advanced oral, pharyngeal, or unknown primary cervical cancer (Table 1)
phase angle (PA) and standardized phase angle (SPA) have been identified as prognostic factors for survival in different cancers and other severe diseases; the current study aimed to investigate whether PA and SPA are prognostic factors for survival in advanced HN cancer

Summary

Introduction

Head and neck (HN) cancer constitutes approximately 4% of all cancer in Western countries and is more common in developing countries [1]. The average relative 5-year survival for HN cancer is approximately 67% in Sweden, but worse for advanced stages III and IV [2]. Bioelectrical impedance analysis (BIA) is an easy-touse, non-invasive method that measures the electrical properties of the patient’s tissues and has been used for many years to assess body composition including fat-free mass [9]. In recent years BIA has been used to measure the phase angle (PA), which appears to be even more interesting for cancer survival [10]. Lower PA values suggest reduced cell mass and/or decreased cellular integrity, whereas a higher PA suggests large quantities of intact cell

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