Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Head and Neck Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Head Neck. 2019 Jun;41(6):1745-1755. doi: 10.1002/hed.25638. Epub 2019 Jan 20.
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).
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).
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.
Low SMM is associated with PCF and prolonged hospital stay in patients undergoing TL. Low SMM is an independent prognostic factor for shorter OS.
低骨骼肌量（SMM）与手术肿瘤学中的术后并发症、住院时间延长和总体生存（OS）缩短有关。我们旨在研究 TL 患者中这种相关性。
对接受 TL 的患者进行回顾性研究。使用 CT 或 MRI 扫描在第三颈椎（C3）水平测量 SMM。
共纳入 235 例患者。109 例（46.4%）患者存在低 SMM。与正常 SMM 患者相比，低 SMM 患者的咽皮瘘（PCF）更多（34.9%比 20.6%；P = 0.02），住院时间延长（中位数，17 天比 14 天；P < 0.001）。多变量分析表明，低 SMM（风险比，1.849；95%置信区间，1.202-2.843）和高 N 期是 OS 降低的显著预后因素。
低 SMM 与 TL 患者的 PCF 和住院时间延长有关。低 SMM 是 OS 缩短的独立预后因素。
