{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T22:58:04Z","timestamp":1772060284855,"version":"3.50.1"},"reference-count":46,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,28]],"date-time":"2023-01-28T00:00:00Z","timestamp":1674864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>For percutaneous endoscopic gastrostomy (PEG)-fed head and neck cancer (HNC) patients, risk markers of poor outcomes may identify those needing more intensive support. This retrospective study aimed to evaluate markers of poor outcomes using TNM-defined stages, initial anthropometry [body mass index (BMI), mid-upper arm circumference (MUAC), tricipital skinfold (TSF), mid-arm muscle circumference (MAMC)] and laboratory data (albumin, transferrin, cholesterol), with 138 patients, 42\u201394 years old, enrolled. The patients had cancer, most frequently in the larynx (n = 52), predominantly stage IV (n = 109). Stage IVc presented a four times greater death risk than stage I (OR 3.998). Most patients presented low parameters: low BMI (n = 76), MUAC (n = 114), TSF (n = 58), MAMC (n = 81), albumin (n = 47), transferrin (n = 93), and cholesterol (n = 53). In stages I, III, IVa, and IVb, MAMC and PEG-timing were major survival determinants. Each MAMC unit increase resulted in 16% death risk decrease. Additional 10 PEG-feeding days resulted in 1% mortality decrease. Comparing IVa\/IVb vs. IVc, albumin and transferrin presented significant differences (p = 0.042; p = 0.008). All parameters decreased as severity of stages increased. HNC patients were malnourished before PEG, with advanced cancer stages, and poor outcomes. Initial MAMC, reflecting lean tissue, significantly increases survival time, highlighting the importance of preserving muscle mass. PEG duration correlated positively with increased survival, lowering death risk by 1% for every additional 10 PEG-feeding days, signaling the need for early gastrostomy.<\/jats:p>","DOI":"10.3390\/nu15030662","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T09:18:21Z","timestamp":1675070301000},"page":"662","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Malnutrition, Cancer Stage and Gastrostomy Timing as Markers of Poor Outcomes in Gastrostomy-Fed Head and Neck Cancer Patients"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7998-6199","authenticated-orcid":false,"given":"Diogo","family":"Sousa-Catita","sequence":"first","affiliation":[{"name":"Grupo de Patologia M\u00e9dica, Nutri\u00e7\u00e3o e Exerc\u00edcio Cl\u00ednico (PaMNEC) do Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal"},{"name":"GENE\u2014Artificial Feeding Team, Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"},{"name":"Resid\u00eancias Montepio\u2014Servi\u00e7os de Sa\u00fade, SA\u2014Rua Julieta Ferr\u00e3o N\u00ba 10\u20135\u00ba, 1600-131 Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cl\u00e1udia","family":"Ferreira-Santos","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6584-1199","authenticated-orcid":false,"given":"Paulo","family":"Mascarenhas","sequence":"additional","affiliation":[{"name":"Grupo de Patologia M\u00e9dica, Nutri\u00e7\u00e3o e Exerc\u00edcio Cl\u00ednico (PaMNEC) do Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e1tia","family":"Oliveira","sequence":"additional","affiliation":[{"name":"GENE\u2014Artificial Feeding Team, Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel","family":"Madeira","sequence":"additional","affiliation":[{"name":"GENE\u2014Artificial Feeding Team, Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0414-9107","authenticated-orcid":false,"given":"Carla Adriana","family":"Santos","sequence":"additional","affiliation":[{"name":"GENE\u2014Artificial Feeding Team, Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carla","family":"Andr\u00e9","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2304-3129","authenticated-orcid":false,"given":"Catarina","family":"Godinho","sequence":"additional","affiliation":[{"name":"Grupo de Patologia M\u00e9dica, Nutri\u00e7\u00e3o e Exerc\u00edcio Cl\u00ednico (PaMNEC) do Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu\u00eds","family":"Antunes","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6477-7028","authenticated-orcid":false,"given":"Jorge","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Grupo de Patologia M\u00e9dica, Nutri\u00e7\u00e3o e Exerc\u00edcio Cl\u00ednico (PaMNEC) do Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal"},{"name":"GENE\u2014Artificial Feeding Team, Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1016\/j.nut.2011.11.003","article-title":"Prevalence of Malnutrition and Nutritional Risk Factors in Patients Undergoing Alcohol and Drug Treatment","volume":"28","author":"Ross","year":"2012","journal-title":"Nutrition"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1177\/0148607112440285","article-title":"Consensus Statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition","volume":"36","author":"White","year":"2012","journal-title":"J. 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