Significance of Anthropometric and Nutritive Factors in Oral and Oropharyngeal Cancer Patients Undergoing Free Flap Reconstruction

Abstract Purpose In this study, associations between preoperative nutritional status and incidence of early postoperative complications as a primary outcome in patients with oral and oropharyngeal cancer undergoing free flap reconstruction were analyzed. The investigators hypothesized that preoperative nutritional status may be linked with specific complications, allowing for better preoperative risk assessment. Methods This retrospective cohort longitudinal study encompassed 113 patients, all treated surgically for oral and oropharyngeal cancer in the period of March 2013 - March 2018 in a tertiary referral center. Variables considered were pre- and postoperative serum albumin and protein values, body-mass index, waist to hip ratio, circumference of the neck, waist, hip, and thigh, number of cigarettes per day during ten years prior to surgery, average alcohol consumption, operative time and postoperative albumin administration. Results Our study has identified preoperative protein serum concentration (≤62g/L), postoperative albumin administration (≥200 mL), number of cigarettes per day (>20) and prolonged operative time (≥450 minutes) to be associated with postoperative complications. Conclusion This is the first study reporting cut-off values of clinical significance in assessing patient preoperative nutritional status, in light of reducing postoperative complications after free-flap reconstruction.