Department of Otorhinolaryngology-Head and Neck Surgery.
Department of Radiation Oncology.
Medicine (Baltimore). 2020 Dec 24;99(52):e23860. doi: 10.1097/MD.0000000000023860.
Malnutrition is common among patients who have oral cavity squamous cell carcinoma (OSCC), but its effect on the incidence of postoperative complications remains uncertain. Validated nutrition and complication assessment tools were used to evaluate the effects of nutrition on the likelihood of postoperative complications after curative surgery for OSCC.A retrospective study that spanned January 2014 to December 2018 enrolled 70 patients who received curative surgery for OSCC. Nutritional status before surgery was evaluated with the scored Patient-Generated Subjective Global Assessment (PG-SGA), and patients were classified as either well-nourished (rating A) or malnourished (ratings B and C). Complications 30 days after the operation were graded using Clavien-Dindo classification. The perioperative clinicopathological characteristics of the groups were compared, and risk factors for postoperative complications were identified through logistic regression.A total of 44 (62.8%) patients formed the malnourished group, and they tended to be older (P = .03), weigh less (P = .001), have lower Body Mass Index (P = .003), higher PG-SGA scores (P < .001), higher neutrophil-to-lymphocyte ratio (P = .034), more postoperative complications (P < .001), and longer hospital stays (P = .021). Major complications (Clavien-Dindo classification ≥ IIIa) were experienced by 18.5% (n = 13) of patients and were more common in the malnourished group (P = .007). Multivariate logistic regression demonstrated that PG-SGA score ≥4 was an independent risk factor for postoperative complications (hazard ratio = 4.929, P = .008).Malnutrition defined using the PG-SGA is an independent risk factor for postoperative complications of curative surgery in patients with OSCC. More prospective studies are warranted to confirm our findings.
营养不良在口腔鳞状细胞癌（OSCC）患者中很常见，但它对术后并发症发生率的影响尚不确定。本研究使用经过验证的营养和并发症评估工具，评估了营养状况对接受 OSCC 根治性手术后发生术后并发症可能性的影响。
这是一项回顾性研究，研究对象为 2014 年 1 月至 2018 年 12 月期间接受 OSCC 根治性手术的 70 例患者。术前通过评分患者主观整体评估（PG-SGA）评估营养状况，患者分为营养良好（评分 A）或营养不良（评分 B 和 C）。术后 30 天的并发症使用 Clavien-Dindo 分级进行分级。比较两组患者围手术期临床病理特征，采用逻辑回归分析确定术后并发症的危险因素。
共有 44 例（62.8%）患者被归入营养不良组，他们往往年龄较大（P=0.03），体重较轻（P=0.001），体重指数（BMI）较低（P=0.003），PG-SGA 评分较高（P<0.001），中性粒细胞与淋巴细胞比值较高（P=0.034），术后并发症较多（P<0.001），住院时间较长（P=0.021）。18.5%（n=13）的患者发生严重并发症（Clavien-Dindo 分级≥IIIa），营养不良组更为常见（P=0.007）。多变量逻辑回归表明，PG-SGA 评分≥4 是术后并发症的独立危险因素（危险比=4.929，P=0.008）。
使用 PG-SGA 定义的营养不良是 OSCC 患者根治性手术后发生术后并发症的独立危险因素。需要更多的前瞻性研究来证实我们的发现。
