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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- Sandra I. Bril
- Department of Head and Neck Surgical Oncology University Medical Center Utrecht Utrecht The Netherlands
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- Thomas F. Pezier
- Department of Head and Neck Surgical Oncology University Medical Center Utrecht Utrecht The Netherlands
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- Bernard M. Tijink
- Department of Head and Neck Surgical Oncology University Medical Center Utrecht Utrecht The Netherlands
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- Luuk M. Janssen
- Department of Head and Neck Surgical Oncology University Medical Center Utrecht Utrecht The Netherlands
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- Weibel W. Braunius
- Department of Head and Neck Surgical Oncology University Medical Center Utrecht Utrecht The Netherlands
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- Remco de Bree
- Department of Head and Neck Surgical Oncology University Medical Center Utrecht Utrecht The Netherlands
説明
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>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).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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%; <jats:italic>P</jats:italic> = .02) and prolonged hospital stay (median, 17 vs 14 days; <jats:italic>P</jats:italic> < .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.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Low SMM is associated with PCF and prolonged hospital stay in patients undergoing TL. Low SMM is an independent prognostic factor for shorter OS.</jats:p></jats:sec>
収録刊行物
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- Head & Neck
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Head & Neck 41 (6), 1745-1755, 2019-01-20
Wiley
