Cachexia at diagnosis is associated with poor survival in head and neck cancer patients

Helena Orell-Kotikangas*, Pia Österlund, Outi Mäkitie, Kauko Saarilahti, Paula Ravasco, Ursula Schwab, Antti A. Mäkitie

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

64 Citations (Scopus)


Conclusions: One third of the patients had cachexia with an association of significantly shorter survival. These results suggest that combining HGS and MAMA seems to be a practical method to screen cachexia in patients with head and neck cancer and may also be used when assessing their prognosis. Objectives: The aim of this study was to analyze the hypothesis that cachexia defined as both low mid-arm muscle area (MAMA) and handgrip strength (HGS) is associated with decreased survival in patients with head and neck squamous cell carcinoma (HNSCC). Methods: Sixty-five consecutive patients with primary HNSCC were enrolled prior to cancer therapy. Cachexia was defined as low handgrip strength (HGS) and low mid-arm muscle area (MAMA). Nutritional status was assessed by patient-generated subjective global assessment (PG-SGA) and sarcopenia by low MAMA. Biochemical parameters reflecting nutritional status and S-25-OHD were measured. Results: Cachexia was seen in 31% and sarcopenia in 46% of patients. Altogether, 34% of patients were malnourished. Disease-free survival was 13 months (3–62) in cachectic patients, compared with 66 months (31–78) in non-cachectic patients (p = 0.009). S-25-OHD was 28 nmol/l in cachectic patients, compared with 46 nmol/l in non-cachectic patients (p = 0.009) and prealbumin 187 mg/l and 269 mg/l, respectively (p < 0.001).
Original languageEnglish
Pages (from-to)778-785
Number of pages8
JournalActa Oto-Laryngologica
Issue number7
Publication statusPublished - 3 Jul 2017
Externally publishedYes


  • Anthropometry
  • Handgrip strength
  • Nutritional status
  • Oncology


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