Preoperative low skeletal muscle mass as a risk factor for pharyngocutaneous fistula and decreased overall survival in patients undergoing total laryngectomy

Sandra I. Bril; Thomas F. Pezier; Bernard M. Tijink; Luuk M. Janssen; Weibel W. Braunius; Remco de Bree

doi:10.1002/hed.25638

Preoperative low skeletal muscle mass as a risk factor for pharyngocutaneous fistula and decreased overall survival in patients undergoing total laryngectomy

Sandra I. Bril, Thomas F. Pezier, Bernard M. Tijink, Luuk M. Janssen, Weibel W. Braunius, Remco de Bree^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

3 Citations (Scopus)

Abstract

BACKGROUND: Low skeletal muscle mass (SMM) is associated with postoperative complications, prolonged hospital stay, and short overall survival (OS) in surgical oncology. We aimed to investigate this association in patients undergoing total laryngectomy (TL).

METHODS: A retrospective study was performed of patients undergoing TL. SMM was measured using CT or MRI scans at the level of the third cervical vertebra (C3).

RESULTS: In all, 235 patients were included. Low SMM was observed in 109 patients (46.4%). Patients with low SMM had more pharyngocutaneous fistulas (PCFs) than patients with normal SMM (34.9% vs 20.6%; P = .02) and prolonged hospital stay (median, 17 vs 14 days; P < .001). In multivariate analysis, low SMM (hazards ratio, 1.849; 95% confidence interval, 1.202-2.843) and high N stage were significant prognosticators of decreased OS.

CONCLUSION: Low SMM is associated with PCF and prolonged hospital stay in patients undergoing TL. Low SMM is an independent prognostic factor for shorter OS.

Original language	English
Pages (from-to)	1745-1755
Number of pages	11
Journal	Head and Neck
Volume	41
Issue number	6
DOIs	https://doi.org/10.1002/hed.25638
Publication status	Published - 1 Jun 2019

Keywords

body composition
computer-assisted image analysis
head and neck neoplasms
postoperative complications
sarcopenia
skeletal muscle mass
surgery
survival

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@article{1eeb2bf20f114faa9debcc9396f76654,

title = "Preoperative low skeletal muscle mass as a risk factor for pharyngocutaneous fistula and decreased overall survival in patients undergoing total laryngectomy",

abstract = "BACKGROUND: Low skeletal muscle mass (SMM) is associated with postoperative complications, prolonged hospital stay, and short overall survival (OS) in surgical oncology. We aimed to investigate this association in patients undergoing total laryngectomy (TL).METHODS: A retrospective study was performed of patients undergoing TL. SMM was measured using CT or MRI scans at the level of the third cervical vertebra (C3).RESULTS: In all, 235 patients were included. Low SMM was observed in 109 patients (46.4%). Patients with low SMM had more pharyngocutaneous fistulas (PCFs) than patients with normal SMM (34.9% vs 20.6%; P = .02) and prolonged hospital stay (median, 17 vs 14 days; P < .001). In multivariate analysis, low SMM (hazards ratio, 1.849; 95% confidence interval, 1.202-2.843) and high N stage were significant prognosticators of decreased OS.CONCLUSION: Low SMM is associated with PCF and prolonged hospital stay in patients undergoing TL. Low SMM is an independent prognostic factor for shorter OS.",

keywords = "body composition, computer-assisted image analysis, head and neck neoplasms, postoperative complications, sarcopenia, skeletal muscle mass, surgery, survival",

author = "Bril, {Sandra I.} and Pezier, {Thomas F.} and Tijink, {Bernard M.} and Janssen, {Luuk M.} and Braunius, {Weibel W.} and {de Bree}, Remco",

note = "Funding Information: Michel Keijzer Fonds, a not for profit fund managed by the Dutch Head and Neck Cancer patient support group, Grant/Award Number: Grant 2017; Michel Keijzer Fonds Publisher Copyright: {\textcopyright} 2019 The Authors. Head & Neck published by Wiley Periodicals, Inc. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.",

year = "2019",

month = jun,

day = "1",

doi = "10.1002/hed.25638",

language = "English",

volume = "41",

pages = "1745--1755",

journal = "Head and Neck",

issn = "1043-3074",

publisher = "John Wiley & Sons Inc.",

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TY - JOUR

T1 - Preoperative low skeletal muscle mass as a risk factor for pharyngocutaneous fistula and decreased overall survival in patients undergoing total laryngectomy

AU - Bril, Sandra I.

AU - Pezier, Thomas F.

AU - Tijink, Bernard M.

AU - Janssen, Luuk M.

AU - Braunius, Weibel W.

AU - de Bree, Remco

N1 - Funding Information: Michel Keijzer Fonds, a not for profit fund managed by the Dutch Head and Neck Cancer patient support group, Grant/Award Number: Grant 2017; Michel Keijzer Fonds Publisher Copyright: © 2019 The Authors. Head & Neck published by Wiley Periodicals, Inc. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.

PY - 2019/6/1

Y1 - 2019/6/1

N2 - BACKGROUND: Low skeletal muscle mass (SMM) is associated with postoperative complications, prolonged hospital stay, and short overall survival (OS) in surgical oncology. We aimed to investigate this association in patients undergoing total laryngectomy (TL).METHODS: A retrospective study was performed of patients undergoing TL. SMM was measured using CT or MRI scans at the level of the third cervical vertebra (C3).RESULTS: In all, 235 patients were included. Low SMM was observed in 109 patients (46.4%). Patients with low SMM had more pharyngocutaneous fistulas (PCFs) than patients with normal SMM (34.9% vs 20.6%; P = .02) and prolonged hospital stay (median, 17 vs 14 days; P < .001). In multivariate analysis, low SMM (hazards ratio, 1.849; 95% confidence interval, 1.202-2.843) and high N stage were significant prognosticators of decreased OS.CONCLUSION: Low SMM is associated with PCF and prolonged hospital stay in patients undergoing TL. Low SMM is an independent prognostic factor for shorter OS.

AB - BACKGROUND: Low skeletal muscle mass (SMM) is associated with postoperative complications, prolonged hospital stay, and short overall survival (OS) in surgical oncology. We aimed to investigate this association in patients undergoing total laryngectomy (TL).METHODS: A retrospective study was performed of patients undergoing TL. SMM was measured using CT or MRI scans at the level of the third cervical vertebra (C3).RESULTS: In all, 235 patients were included. Low SMM was observed in 109 patients (46.4%). Patients with low SMM had more pharyngocutaneous fistulas (PCFs) than patients with normal SMM (34.9% vs 20.6%; P = .02) and prolonged hospital stay (median, 17 vs 14 days; P < .001). In multivariate analysis, low SMM (hazards ratio, 1.849; 95% confidence interval, 1.202-2.843) and high N stage were significant prognosticators of decreased OS.CONCLUSION: Low SMM is associated with PCF and prolonged hospital stay in patients undergoing TL. Low SMM is an independent prognostic factor for shorter OS.

KW - body composition

KW - computer-assisted image analysis

KW - head and neck neoplasms

KW - postoperative complications

KW - sarcopenia

KW - skeletal muscle mass

KW - surgery

KW - survival

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U2 - 10.1002/hed.25638

DO - 10.1002/hed.25638

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SN - 1043-3074

VL - 41

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EP - 1755

JO - Head and Neck

JF - Head and Neck

IS - 6

ER -

Preoperative low skeletal muscle mass as a risk factor for pharyngocutaneous fistula and decreased overall survival in patients undergoing total laryngectomy

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