Abstract
Purpose: 1. To understand practice patterns among head and neck surgeons and radiation oncologists in the assessment and management of malnutrition in head and neck cancer patients. 2. To identify barriers that prevent the identification of and intervention upon malnutrition.
Background: Among patients who undergo surgery for head and neck cancer, there is a strong association between severe malnutrition and increased postoperative complications, length of stay, and cost of care. We aim to evaluate the association between the type of head and neck cancer provider and their comfort with the diagnosis and management of malnutrition in this patient population.
Methods: A 17-question survey was distributed to 1,392 members of the American Head and Neck Society (AHNS) between 04/01/2018 and 04/18/2018. Chi squared testing was used to perform subgroup analysis by hospital type, fellowship training, clinical experience, and specialty.
Results: The response rate among AHNS members was 9%, with 124 total respondents, including both otolaryngologists and radiation oncologists. There was strong agreement among respondents that malnutrition is important to identify and negatively impacts the quality of life, cost of care, length of hospital stay, mortality, and postoperative complications. The majority of respondents stated that although they were comfortable with screening for malnutrition, they were not familiar with the National Comprehensive Cancer Network (NCCN) guidelines on nutrition screening and intervention. Respondents reported use of various screening tools including serum markers, body mass index (BMI), and weight loss. Subgroup analysis demonstrated that otolaryngologists and academic hospitals were significantly more likely to screen by lab markers compared to radiation oncologists and community hospitals (p<0.05). Furthermore, although familiarity with NCCN guidelines was poor, fellowship-trained head and neck surgeons felt significantly more comfortable in their knowledge of NCCN guidelines than those without additional training (p<0.05). Barriers to screening for malnutrition included lack of training or familiarity with screening tools and guidelines, as well as lack of access to ancillary staff, such as nutritionists and speech therapists.
Conclusion: There was a strong consensus among respondents that identification and management of malnutrition among head and neck cancer patients is important. However, familiarity with guidelines on screening and treating malnutrition was lacking, occasionally leading to practice patterns that deviated from the best available evidence.
Citation Format: Amarbir S. Gill, Michael Kinzinger, Michael G. Moore. Malnutrition evaluation in head and neck cancer patients: Practice patterns among otolaryngologists and radiation oncologists [abstract]. In: Proceedings of the AACR-AHNS Head and Neck Cancer Conference: Optimizing Survival and Quality of Life through Basic, Clinical, and Translational Research; 2019 Apr 29-30; Austin, TX. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(12_Suppl_2):Abstract nr B19.
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