Do Nutritional and Inflammatory Biomarkers Have Prognostic Significance in the Early Post Operative Period in Head and Neck Cancer? – A Pilot Study
Keywords:Prognostic significance, inflammatory parameters, wound infection (WI) rates, pathological diagnosis, Nutritional Risk Index (NRI)
AbstractThis pilot study evaluated prognostic significance of patient/tumor factors and nutritional/inflammatory parameters with respect to the early post operative complications such as Wound Infection (WI) rates and Length of Hospital Stay (LOS) in 26 Head and Neck Cancer (HNC) surgical patients. The prognostic indices were calculated using patient and tumor related variables including age, sex, co-morbidity, tobacco usage, pathological diagnosis, hemoglobin (Hb) and albumin. The WI rate in the present study was found to be 30% and significantly correlated with both tobacco usage (p=0.021) and nutritional indices such as Albumin/ Globulin ratio (A/G) (p = 0.034) and Nutritional Risk Index (NRI) (p = 0.043). LOS (9.32 ± 2.719) was significantly correlated to Albumin levels (p = 0.002), A/G ratio (p = 0.02) and Prognostic Nutritional Index (PNI) (p = 0.006) and NRI (p = 0.002). This pilot study suggested that a positive history of tobacco usage and immune nutritional factors may influence early post-operative outcomes in head and neck surgery.
W., S., P., Wild, C. and International Agency for Research on Cancer Content Provider. World Cancer Report, Geneva: World Health Organization, 2014.
Torre, L., Bray, F., Siegel, R., Ferlay, J., Lortet Tieulent, J. and Jemal, A. Global cancer statistics, 2012. CA: A Cancer J.Clin., 2015, 65(2), 87-108.
Sorensen, L., McCarthy, M., Baumgartner, M. and Demars, C. (2009). Perioperative immunonutrition in head and neck cancer. Laryngoscope, 119(7), 1358-1364.
Stableforth, Thomas, & Lewis. A systematic review of the role of immunonutrition in patients undergoing surgery for head and neck cancer. Int. J.Oral and Maxillofacial Surgery, 2009, 38(2), 103-110.
Sorensen, L., McCarthy, M., Baumgartner, M. and Demars, C. (2009). Perioperative immunonutrition in head and neck cancer. Laryngoscope,119(7), 1358-1364.
Magnano, M., Mola, P., Machetta, G., Maffeis, P., Forestiero, I., Cavagna, R. and Boffano, P. The nutritional assessment of head and neck cancer patients. Eur. Arch.Oto-Rhino-Laryngol., 2015, 272(12), 3793-3799.
Bokhorst-de van der Schueren, M.A.E., Leeuwen, van, P.A.M., Kuik, D.J., Klop, W.M.C., Sauerwein, H.P., Snow, G.B. and Quak, J.J. The impact of nutritional status on the prognoses of patients with advanced head and neck cancer. Cancer, 1999, 86, 519-527.
Yang, Lin, Xia, Liangping, Wang, Yan, Hong, Shaodong, Chen, Haiyang, Liang, Shaobo, Williams, Bart O. Low Prognostic Nutritional Index (PNI) predicts unfavorable distant metastasis-free survival in nasopharyngeal carcinoma: a propensity score-matched analysis.PLoS ONE, 11(7), 2016, 11(7).
Isabel T.D. Correia and Waitzberg. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin.Nutr., 22(3), 235-239.
Chaukar, Devendra, Deshmukh, Anuja, Majeed, Tanveer, Chaturvedi, Pankaj, Pai, Prathamesh, and D'Cruz, Anil. Factors affecting wound complications in head and neck surgery: A prospective study. Ind. J. Med.Paediat. Oncol., 2013, 34(4), 247-251.
Milisavljevií¦, D., Stankovií¦, M., Zivií¦, M. and Stankovií¦, P. Head and neck cancer surgery in elderly: Complications and survival rate. Coll. Antropol., 2012, 36(2), 13-17.
Penel, Nicolas, Fournier, Charles, Lefebvre, Danièle and Lefebvre, Jean-Louis. Multivariate analysis of risk factors for wound infection in head and neck squamous cell carcinoma surgery with opening of mucosa. Study of 260 surgical procedures. Oral Oncol., 2005, 41(3), 294-303.
Penel, Nicolas, Lefebvre, Daniéle, Fournier, Charles, Sarini, Jèrome, Kara, Ahmed and Lefebvre, Jean Louis. Risk factors for wound infection in head and neck cancer surgery: A prospective study. Head and Neck, 2001, 23(6), 447-455.
Hirakawa, H., Hasegawa, Y., Hanai, N., Ozawa, T., Hyodo, I. and Suzuki, M. Surgical site infection in clean-contaminated head and neck cancer surgery: Risk factors and prognosis.Euro. Arch. Oto-Rhino-Laryngol., 2013, 270(3), 1115-1123.
Danan, D., Shonka, D., Selman, Y., Chow, Z., Smolkin, M. and Jameson, M. Prognostic value of albumin in patients with head and neck cancer. Laryngoscope, 2016, 126(7), 1567-1571.
Lotfi, Cavalcanti, Silva, Dias de Oliveira Latorre, De Cássia Braga Ribeiro, Carvalho and Kowalski. Risk factors for surgical-site infections in head and neck cancer surgery.Otolaryngology - Head and Neck Surgery, 2008, 138(1), 74-80.
Shinkawa, H., Takemura, S., Uenishi, T., Sakae, M., Ohata, K., Urata, Y. and Kubo, S.
Nutritional risk index as an independent predictive factor for the development of surgical site infection after pancreaticoduodenectomy. Surgery Today, 2013, 43(3), 276-283.
Raikundalia, M., Fang, C., Spinazzi, E., Vazquez, A., Park, R., Baredes, S. and Eloy, J.
Impact of diabetes mellitus on head and neck cancer patients undergoing surgery.Otolaryngology-Head and Neck Surgery, 2016, 154(2), 294-299.
Fiorini, F., Deganello, A., Larotonda, G., Mannelli, G. and Gallo, O. Tobacco exposure and complications in conservative laryngeal surgery. Cancers, 2014, 6(3), 1727-1735.
Park, S., Kim, M., Eom, J., Lee, J. and Rho, Y. Risk factors and etiology of surgical site infection after radical neck dissection in patients with head and neck cancer. Kor. J. Int.Med., 2016, 31(1), 162-169.
Kao, Huang-Kai, Chen, Wei F., Chen, Chih-Hao, Shyu, Victor Bong-Hang, Cheng, MingHuei and Chang, Kai-Ping. The roles of albumin levels in head and neck cancer patients with liver cirrhosis undergoing tumor ablation and microsurgical free tissue transfer. PLoS ONE, 2012, 7 (12), E52678.
Gibbs, James. Preoperative serum albumin level as a predictor of operative mortality and morbidity: Results from the National VA surgical risk study. (Abstract). JAMA, J. Am. Med.Assoc., 1999, 281(18), 1682.
Aziz, E., Javed, F., Pratap, B., Musat, D., Nader, A., Pulimi, S. and Kukin, M. Malnutrition as assessed by nutritional risk index is associated with worse outcome in patients admitted with acute decompensated heart failure: An ACAP-HF data analysis. Heart Int., 2011, 6(1).
Georgia Tsaousi, Stavros Panidis, George Stavrou, John Tsouskas, Dimitrios Panagiotou and katerina kotzampassi. prognostic indices of poor nutritional status and their impact on prolonged hospital stay in a greek university hospital. Bio.Med. Res. Int., 2014, 924270.
Wakahara, Shiraki, Murase, Fukushima, Matsuura, Fukao and Moriwaki. Nutritional screening with subjective global assessment predicts hospital stay in patients with digestive diseases. Nutr., 2007, 23(9), 634-639.
White, L., Zhang, H., Strickland, K., El-Deiry, M., Patel, M., Wadsworth, J. and Chen, A.Factors associated with hospital length of stay following fibular free-tissue reconstruction of head and neck defects: Assessment using the american college of surgeons national surgical quality improvement program (ACS NSQIP) Criteria. JAMA Otolaryngology-Head and Neck Surgery, 2015, 141(12), 1052-1058.
Gohil, R., Rishi, M. and Tan, B. Pre-operative serum albumin and neutrophil-lymphocyte ratio are associated with prolonged hospital stay following colorectal cancer surgery.Brit. J. Med. Med. Res., 2014, 4(1), 481-487.
Hatcher, J., Sterba, K., Tooze, J., Day, T., Carpenter, M., Alberg, A. and Weaver, K. Tobacco use and surgical outcomes in patients with head and neck cancer. Head and Neck, 2016, 38 (5), 700-706.
Cheong Ah Oh, Dae Hoon Kim, Seung Jong Oh, Min Gew Choi, Jae Hyung Noh, Tae Sung Sohn, Jae Moon Bae and Sung Kim. Nutritional risk index as a predictor of postoperative wound complications after gastrectomy, World J. Gastroenterol., 2012, 18(7), 673-678.
How to Cite
All the articles published in IJND are distributed under a creative commons license. The journal allows the author(s) to hold the copyright of their work (all usages allowed except for commercial purpose).
Please contact us at firstname.lastname@example.org for permissions related to commercial use of the article(s).