Does perioperative oxandrolone improve nutritional status in patients with cachexia related to head and neck carcinoma?

BACKGROUND: Cancer cachexia affects up to over 50% of advanced head and neck cancer (HNC) patients. To date, the potential utility of anabolic steroids in perioperative cachectic HNC patients has not been determined. METHODS: Retrospective review of pre‐ and post‐oxandrolone administration prealbumin levels in 18 perioperative HNC patients between October 2007 and October 2014 at a tertiary academic medical center. RESULTS: The median pretreatment prealbumin was 88.5 mg/L. The median post‐treatment prealbumin was 227 mg/L. The median interval improvement of the prealbumin level was 131.5 mg/L. The median differences between the pretreatment and post‐treatment prealbumin levels were found to be statistically significant (P < .001). Subjective improvement in wound healing was also observed. CONCLUSIONS: Perioperative administration of oxandrolone resulted in objective improvements in prealbumin levels and subjective improvements in surgical wounds. Oxandrolone administered 10 mg twice daily (BID) for 10 days may be a useful adjunct in the perioperative care of nutritionally deficient HNC patients who are at risk for or have demonstrated impaired wound healing. LEVEL OF EVIDENCE: 3