Investigation of p16 status, chemotherapy regimen, and other nutrition markers for predicting gastrostomy in patients with head and neck cancer

• DOI: 10.1002/hed.24630
• Publication Date: 2017-02-23T16:19:31Z
• Authors: Teresa E. Brown; Kym Wittholz; Mandy Way; Merrilyn D. Banks; Brett G. M. Hughes; Charles Y. Lin; Lizbeth M. Kenny; Judith D. Bauer
• Keywords: 2. Zero hunger; Human papillomavirus (HPV); Gastrostomy; Male; Malnutrition; Nutritional Status; Antineoplastic Agents; Middle Aged; 3. Good health; 03 medical and health sciences; 2733 Otorhinolaryngology; 0302 clinical medicine; Head and Neck Neoplasms; Risk Factors; Chemotherapy; Humans; Female; Head and neck cancer; Cyclin-Dependent Kinase Inhibitor p16; Aged; Neoplasm Staging; Retrospective Studies

AbstractBackgroundThe purpose of this study was to determine if p16 status, chemotherapy regimen, or other nutrition markers could improve protocol accuracy in predicting proactive gastrostomy in patients with head and neck cancer.MethodsPatients who received curative treatment from July 2010 to June 2011 were included (n = 269). Associations among dependent variables (age, sex, tumor site, staging, treatment, p16 status, albumin, and Malnutrition Screening Tool [MST] score), the protocol risk rating, and requirement for proactive gastrostomy were examined.ResultsCurrent protocol correctly identified 81 of 88 high‐risk patients (92%) for gastrostomy, but incorrectly classified 32 of 181 low‐risk patients (18%). Analysis of low‐risk patients with oral or oropharyngeal cancers, found p16‐positive disease had 4.4 times greater odds (p = .049), and those at risk of malnutrition had 4.5 times greater odds (p = .019) of requiring gastrostomy.ConclusionMalnutrition risk and p16 status could be used to identify further patients who may benefit from proactive gastrostomy. © 2017 Wiley Periodicals, Inc. Head Neck 39: 868–875, 2017