Skip to main content
Erschienen in: Supportive Care in Cancer 6/2015

01.06.2015 | Original Article

NRS-2002 for pre-treatment nutritional risk screening and nutritional status assessment in head and neck cancer patients

verfasst von: Helena Orell-Kotikangas, Pia Österlund, Kauko Saarilahti, Paula Ravasco, Ursula Schwab, Antti A. Mäkitie

Erschienen in: Supportive Care in Cancer | Ausgabe 6/2015

Einloggen, um Zugang zu erhalten

Abstract

Background

The aim of this study was to assess the value of nutritional risk screening-2002 (NRS-2002) as a nutritional risk screening and status assessment method and to compare it with nutritional status assessed by subjective and objective methods in the screening of head and neck cancer patients.

Methods

Sixty-five consecutive patients (50 male), with a median age of 61 years (range, 33–77), with head and neck squamous cell carcinoma (HNSCC) were enrolled prior to cancer therapy. Nutritional status was assessed by NRS-2002, patient-generated subjective global assessment (PG-SGA), handgrip strength (HGS) and mid-arm muscle area (MAMA).

Results

Twenty-eight percent of patients were at nutritional risk based on NRS-2002, and 34 % were malnourished according to PG-SGA, while 43 % had low HGS. NRS-2002 cut-off score of ≥3 compared with the nutritional status according to PG-SGA showed 77 % specificity and 98 % sensitivity (K = 0.78). NRS-2002 was able to predict malnutrition (PG-SGA BC) both in men (p < 0.001) and in women (p < 0.05). NRS-2002 identified correctly patients with malnutrition with a score of ≥3 (p < 0.001) and risk patients with a score of ≥2 (p < 0.001).

Conclusions

These results suggest that NRS-2002 seems to be a reliable indicator of malnutrition, while NRS-2002 with the cut-off score of ≥2 seems to be more reliable for nutrition screening in head and neck cancer patients prior to oncological treatment.
Literatur
1.
Zurück zum Zitat Righini C, Timi N, Junet P, Bertolo A, Reyt E, Atallah I (2013) Assessment of nutritional status at the time of diagnosis in patients treated for head and neck cancer. Eur Ann Otorhinolaryngol Head Neck Dis 130(1):8–14CrossRefPubMed Righini C, Timi N, Junet P, Bertolo A, Reyt E, Atallah I (2013) Assessment of nutritional status at the time of diagnosis in patients treated for head and neck cancer. Eur Ann Otorhinolaryngol Head Neck Dis 130(1):8–14CrossRefPubMed
2.
Zurück zum Zitat Ravasco P, Monteiro-Grillo I, Marques Vidal P, Camilo ME (2005) Impact of nutrition on outcome: a prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy. Head Neck 27(8):659–668CrossRefPubMed Ravasco P, Monteiro-Grillo I, Marques Vidal P, Camilo ME (2005) Impact of nutrition on outcome: a prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy. Head Neck 27(8):659–668CrossRefPubMed
3.
Zurück zum Zitat Datema FR, Ferrier MB, Baatenburg de Jong RJ (2011) Impact of severe malnutrition on short-term mortality and overall survival in head and neck cancer. Oral Oncol 47(9):910–914CrossRefPubMed Datema FR, Ferrier MB, Baatenburg de Jong RJ (2011) Impact of severe malnutrition on short-term mortality and overall survival in head and neck cancer. Oral Oncol 47(9):910–914CrossRefPubMed
4.
Zurück zum Zitat Jager-Wittenaar H, Dijkstra PU, Vissink A, Langendijk JA, van der Laan BF, Pruim J et al (2011) Changes in nutritional status and dietary intake during and after head and neck cancer treatment. Head Neck 33(6):863–870CrossRefPubMed Jager-Wittenaar H, Dijkstra PU, Vissink A, Langendijk JA, van der Laan BF, Pruim J et al (2011) Changes in nutritional status and dietary intake during and after head and neck cancer treatment. Head Neck 33(6):863–870CrossRefPubMed
5.
Zurück zum Zitat Lees J (1999) Incidence of weight loss in head and neck cancer patients on commencing radiotherapy treatment at a regional oncology centre. Eur J Cancer Care (Engl) 8(3):133–136CrossRef Lees J (1999) Incidence of weight loss in head and neck cancer patients on commencing radiotherapy treatment at a regional oncology centre. Eur J Cancer Care (Engl) 8(3):133–136CrossRef
6.
Zurück zum Zitat Matthews TW, Lampe HB, Dragosz K (1995) Nutritional status in head and neck cancer patients. J Otolaryngol 24(2):87–91PubMed Matthews TW, Lampe HB, Dragosz K (1995) Nutritional status in head and neck cancer patients. J Otolaryngol 24(2):87–91PubMed
7.
Zurück zum Zitat van Bokhorst-de van der Schueren MA, van Leeuwen PA, Sauerwein HP, Kuik DJ, Snow GB, Quak JJ (1997) Assessment of malnutrition parameters in head and neck cancer and their relation to postoperative complications. Head Neck 19(5):419–425CrossRefPubMed van Bokhorst-de van der Schueren MA, van Leeuwen PA, Sauerwein HP, Kuik DJ, Snow GB, Quak JJ (1997) Assessment of malnutrition parameters in head and neck cancer and their relation to postoperative complications. Head Neck 19(5):419–425CrossRefPubMed
8.
Zurück zum Zitat Jager-Wittenaar H, Dijkstra PU, Vissink A, van der Laan BF, van Oort RP, Roodenburg JL (2007) Critical weight loss in head and neck cancer-prevalence and risk factors at diagnosis: an explorative study. Support Care Cancer 15(9):1045–1050CrossRefPubMed Jager-Wittenaar H, Dijkstra PU, Vissink A, van der Laan BF, van Oort RP, Roodenburg JL (2007) Critical weight loss in head and neck cancer-prevalence and risk factors at diagnosis: an explorative study. Support Care Cancer 15(9):1045–1050CrossRefPubMed
9.
Zurück zum Zitat Platek ME, Reid ME, Wilding GE, Jaggernauth W, Rigual NR, Hicks WL Jr et al (2011) Pretreatment nutritional status and locoregional failure of patients with head and neck cancer undergoing definitive concurrent chemoradiation therapy. Head Neck 33(11):1561–1568CrossRefPubMedCentralPubMed Platek ME, Reid ME, Wilding GE, Jaggernauth W, Rigual NR, Hicks WL Jr et al (2011) Pretreatment nutritional status and locoregional failure of patients with head and neck cancer undergoing definitive concurrent chemoradiation therapy. Head Neck 33(11):1561–1568CrossRefPubMedCentralPubMed
10.
Zurück zum Zitat van Bokhorst-De van der Schuer MA, von Blomberg-van der Flier BM, Riezebos RK, Scholten PE, Quak JJ, Snow GB et al (1998) Differences in immune status between well-nourished and malnourished head and neck cancer patients. Clin Nutr 17(3):107–111CrossRefPubMed van Bokhorst-De van der Schuer MA, von Blomberg-van der Flier BM, Riezebos RK, Scholten PE, Quak JJ, Snow GB et al (1998) Differences in immune status between well-nourished and malnourished head and neck cancer patients. Clin Nutr 17(3):107–111CrossRefPubMed
11.
Zurück zum Zitat Van Bokhorst-de Van der Schuer MA, Langendoen SI, Vondeling H, Kuik DJ, Quak JJ, Van Leeuwen PA (2000) Perioperative enteral nutrition and quality of life of severely malnourished head and neck cancer patients: a randomized clinical trial. Clin Nutr 19(6):437–444CrossRefPubMed Van Bokhorst-de Van der Schuer MA, Langendoen SI, Vondeling H, Kuik DJ, Quak JJ, Van Leeuwen PA (2000) Perioperative enteral nutrition and quality of life of severely malnourished head and neck cancer patients: a randomized clinical trial. Clin Nutr 19(6):437–444CrossRefPubMed
12.
Zurück zum Zitat Van Cutsem E, Arends J (2005) The causes and consequences of cancer-associated malnutrition. Eur J Oncol Nurs 9(Suppl 2):S51–S63CrossRefPubMed Van Cutsem E, Arends J (2005) The causes and consequences of cancer-associated malnutrition. Eur J Oncol Nurs 9(Suppl 2):S51–S63CrossRefPubMed
13.
Zurück zum Zitat Malone A, Hamilton C (2013) The academy of nutrition and dietetics/the american society for parenteral and enteral nutrition consensus malnutrition characteristics: application in practice. Nutr Clin Pract 28(6):639–650CrossRefPubMed Malone A, Hamilton C (2013) The academy of nutrition and dietetics/the american society for parenteral and enteral nutrition consensus malnutrition characteristics: application in practice. Nutr Clin Pract 28(6):639–650CrossRefPubMed
14.
Zurück zum Zitat Ottery FD (1996) Definition of standardized nutritional assessment and interventional pathways in oncology. Nutrition 12(1 Suppl):S15–S19 [review] [21 refs]CrossRefPubMed Ottery FD (1996) Definition of standardized nutritional assessment and interventional pathways in oncology. Nutrition 12(1 Suppl):S15–S19 [review] [21 refs]CrossRefPubMed
15.
Zurück zum Zitat Bauer J, Capra S, Ferguson M (2002) Use of the scored patient-generated subjective global assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr 56(8):779–785CrossRefPubMed Bauer J, Capra S, Ferguson M (2002) Use of the scored patient-generated subjective global assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr 56(8):779–785CrossRefPubMed
16.
Zurück zum Zitat Kondrup J, Rasmussen HH, Hamberg O, Stanga Z, ESPEN Ad Hoc Working G. (2003) Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr 22(3):321–336CrossRefPubMed Kondrup J, Rasmussen HH, Hamberg O, Stanga Z, ESPEN Ad Hoc Working G. (2003) Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr 22(3):321–336CrossRefPubMed
17.
Zurück zum Zitat Kondrup J, Allison SP, Elia M, Vellas B, Plauth M (2003) Educational and Clinical Practice Committee, European Society of Parenteral and Enteral Nutrition (ESPEN). ESPEN guidelines for nutrition screening 2002. Clin Nutr 22(4):415–421 [see comment]CrossRefPubMed Kondrup J, Allison SP, Elia M, Vellas B, Plauth M (2003) Educational and Clinical Practice Committee, European Society of Parenteral and Enteral Nutrition (ESPEN). ESPEN guidelines for nutrition screening 2002. Clin Nutr 22(4):415–421 [see comment]CrossRefPubMed
18.
Zurück zum Zitat Isenring E, Bauer J, Capra S (2003) The scored patient-generated subjective global assessment (PG-SGA) and its association with quality of life in ambulatory patients receiving radiotherapy. Eur J Clin Nutr 57(2):305–309CrossRefPubMed Isenring E, Bauer J, Capra S (2003) The scored patient-generated subjective global assessment (PG-SGA) and its association with quality of life in ambulatory patients receiving radiotherapy. Eur J Clin Nutr 57(2):305–309CrossRefPubMed
19.
Zurück zum Zitat Ottery FD (1994) Rethinking nutritional support of the cancer patient: the new field of nutritional oncology. Semin Oncol 21(6):770–778 [review] [103 refs]PubMed Ottery FD (1994) Rethinking nutritional support of the cancer patient: the new field of nutritional oncology. Semin Oncol 21(6):770–778 [review] [103 refs]PubMed
20.
Zurück zum Zitat Ravasco P, Monteiro-Grillo I, Vidal PM, Camilo ME (2003) Nutritional deterioration in cancer: the role of disease and diet. Clin Oncol (R Coll Radiol) 15(8):443–450CrossRef Ravasco P, Monteiro-Grillo I, Vidal PM, Camilo ME (2003) Nutritional deterioration in cancer: the role of disease and diet. Clin Oncol (R Coll Radiol) 15(8):443–450CrossRef
21.
Zurück zum Zitat Frisancho AR (2008) Anthropometric standards. an interactive nutritional reference of body size and body composition for children and adults, 2nd edn. The University of Michigan Press, United States of America Frisancho AR (2008) Anthropometric standards. an interactive nutritional reference of body size and body composition for children and adults, 2nd edn. The University of Michigan Press, United States of America
22.
Zurück zum Zitat Gurney JM, Jelliffe DB (1973) Arm anthropometry in nutritional assessment: nomogram for rapid calculation of muscle circumference and cross-sectional muscle and fat areas. Am J Clin Nutr 26(9):912–915PubMed Gurney JM, Jelliffe DB (1973) Arm anthropometry in nutritional assessment: nomogram for rapid calculation of muscle circumference and cross-sectional muscle and fat areas. Am J Clin Nutr 26(9):912–915PubMed
23.
Zurück zum Zitat Frisancho AR (1974) Triceps skin fold and upper arm muscle size norms for assessment of nutrition status. Am J Clin Nutr 27(10):1052–1058PubMed Frisancho AR (1974) Triceps skin fold and upper arm muscle size norms for assessment of nutrition status. Am J Clin Nutr 27(10):1052–1058PubMed
24.
Zurück zum Zitat Peters MJ, van Nes SI, Vanhoutte EK, Bakkers M, van Doorn PA, Merkies IS et al (2011) Revised normative values for grip strength with the Jamar dynamometer. J Peripher Nerv Syst 16(1):47–50CrossRefPubMed Peters MJ, van Nes SI, Vanhoutte EK, Bakkers M, van Doorn PA, Merkies IS et al (2011) Revised normative values for grip strength with the Jamar dynamometer. J Peripher Nerv Syst 16(1):47–50CrossRefPubMed
25.
Zurück zum Zitat Taylor R (1990) Interpretation of the correlation: coefficient: a basic review. JDMS 1:35–39 Taylor R (1990) Interpretation of the correlation: coefficient: a basic review. JDMS 1:35–39
26.
Zurück zum Zitat Altman DG, Machin D, Bryant TN, Gardner MJ (eds) (2000) Statistics with confidence. BMJ Books, London Altman DG, Machin D, Bryant TN, Gardner MJ (eds) (2000) Statistics with confidence. BMJ Books, London
27.
Zurück zum Zitat Bozzetti F, Mariani L, Lo Vullo S, SCRINIO Working Group, Amerio ML, Biffi R et al (2012) The nutritional risk in oncology: a study of 1,453 cancer outpatients. Support Care Cancer 20(8):1919–1928CrossRefPubMedCentralPubMed Bozzetti F, Mariani L, Lo Vullo S, SCRINIO Working Group, Amerio ML, Biffi R et al (2012) The nutritional risk in oncology: a study of 1,453 cancer outpatients. Support Care Cancer 20(8):1919–1928CrossRefPubMedCentralPubMed
28.
Zurück zum Zitat Almeida AI, Correia M, Camilo M, Ravasco P (2012) Nutritional risk screening in surgery: valid, feasible, easy! Clin Nutr 31(2):206–211CrossRefPubMed Almeida AI, Correia M, Camilo M, Ravasco P (2012) Nutritional risk screening in surgery: valid, feasible, easy! Clin Nutr 31(2):206–211CrossRefPubMed
29.
Zurück zum Zitat Ryu SW, Kim IH (2010) Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients. World J Gastroenterol 16(26):3310–3317CrossRefPubMedCentralPubMed Ryu SW, Kim IH (2010) Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients. World J Gastroenterol 16(26):3310–3317CrossRefPubMedCentralPubMed
30.
Zurück zum Zitat Raslan M, Gonzalez MC, Torrinhas RS, Ravacci GR, Pereira JC, Waitzberg DL (2011) Complementarity of subjective global assessment (SGA) and nutritional risk screening 2002 (NRS 2002) for predicting poor clinical outcomes in hospitalized patients. Clin Nutr 30(1):49–53CrossRefPubMed Raslan M, Gonzalez MC, Torrinhas RS, Ravacci GR, Pereira JC, Waitzberg DL (2011) Complementarity of subjective global assessment (SGA) and nutritional risk screening 2002 (NRS 2002) for predicting poor clinical outcomes in hospitalized patients. Clin Nutr 30(1):49–53CrossRefPubMed
Metadaten
Titel
NRS-2002 for pre-treatment nutritional risk screening and nutritional status assessment in head and neck cancer patients
verfasst von
Helena Orell-Kotikangas
Pia Österlund
Kauko Saarilahti
Paula Ravasco
Ursula Schwab
Antti A. Mäkitie
Publikationsdatum
01.06.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 6/2015
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-014-2500-0

Weitere Artikel der Ausgabe 6/2015

Supportive Care in Cancer 6/2015 Zur Ausgabe

Positiver FIT: Die Ursache liegt nicht immer im Dickdarm

27.05.2024 Blut im Stuhl Nachrichten

Immunchemischer Stuhltest positiv, Koloskopie negativ – in solchen Fällen kann die Blutungsquelle auch weiter proximal sitzen. Ein Forschungsteam hat nachgesehen, wie häufig und in welchen Lokalisationen das der Fall ist.

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

ADT zur Radiatio nach Prostatektomie: Wenn, dann wohl länger

24.05.2024 Prostatakarzinom Nachrichten

Welchen Nutzen es trägt, wenn die Strahlentherapie nach radikaler Prostatektomie um eine Androgendeprivation ergänzt wird, hat die RADICALS-HD-Studie untersucht. Nun liegen die Ergebnisse vor. Sie sprechen für länger dauernden Hormonentzug.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.