ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2026
Weight loss despite nutritional support predicts poor outcomes after postoperative chemoradiotherapy for high-risk head and neck cancer.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeWeight loss is common in patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC) and is associated with poor prognosis. However, its prognostic significance in patients receiving nutritional support from surgery through postoperative chemoradiotherapy (CRT) remains unclear. We evaluated the impact of treatment-related weight loss on clinical outcomes in this setting.
methodsThis retrospective study included patients with high-risk LA-HNSCC treated with surgery, postoperative CRT, and nutritional intervention. Pre-CRT weight loss was defined as the percentage weight loss between surgery and CRT initiation and analyzed using a 5% cutoff. Associations with recurrence-free survival (RFS), overall survival (OS), and adverse events (AEs) were evaluated.
resultsA total of 105 patients were included. Median pre-CRT and overall weight loss were 4.8% and 7.9%, respectively. Patients with recurrence experienced greater pre-CRT weight loss than those without recurrence (6.1% vs. 4.0%, p = 0.004). Patients with ≥ 5% pre-CRT weight loss had significantly worse RFS and OS (log-rank p = 0.001 and p < 0.001). In multivariable analysis, ≥ 5% pre-CRT weight loss remained independently associated with poorer RFS (hazard ratio 2.54, 95% confidence interval 1.35-4.80). The incidence of grade ≥ 3 AEs was comparable between groups (81.8% vs. 86.0%, p = 0.75).
conclusionPre-CRT weight loss of ≥ 5% was independently associated with poorer RFS in patients with high-risk LA-HNSCC undergoing surgery followed by postoperative CRT despite nutritional intervention. Pre-CRT weight loss may be a simple and clinically useful prognostic marker in this setting.
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