EFFECTS OF ZINC AND NUTRITIONAL-STATUS ON CLINICAL OUTCOMES IN HEAD AND NECK-CANCER

The head and neck cancer patient often presents with both protein maln utrition and trace element deficiencies. Zinc has been found to be def icient in many head and neck cancer patients. In this study, pretreatm ent zinc status and nutritional status (measured by the Prognostic Nut ritional Index [PNI]) were correlated with clinical outcomes in 47 pat ients. The patients were followed-up for a median of 52 mo from the ti me of enrollment. Our results showed that the tumor size and overall s tage correlated significantly to zinc status whereas no such correlati on was seen with PNI alcohol intake, or smoking in our subjects. The r esults also showed that impaired zinc status was associated with an in creased number of treatment morbidities, unplanned hospitalizations, a nd treatment delays (P < 0.05). Nutritional status was not associated with any studied outcome variable. The disease-free interval was highe st for the group which had both zinc-sufficient and nutrition-sufficie nt status. Although our data do not prove conclusively, they do sugges t that impaired zinc status at presentation may contribute to treatmen t morbidity, and that for an optimal mean disease-free interval, a suf ficient zinc and nutritional status is required. Nutrition 1998;14:489 -495. (C)Elsevier Science Inc. 1998.