Association of the preoperative body mass index with postoperative complications after treatment of oral squamous cell carcinoma

Publication date: Available online 8 March 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Susanne Wolfer, Annika Kunzler, Stefan Schultze-Mosgau
PurposeNutritional status is believed to influence surgical outcome. Because of a lack of actual reports in literature, the purpose of this study is to evaluate the surgical outcome of patients after treatment for oral squamous cell carcinoma (OSCC), with special focus on the preoperative body mass index (BMI).Patients and methodsThis retrospective cohort study investigates the association of the preoperative BMI with the surgical outcome for OSCC patients, focusing on local and medical complications. This research also analyzes common clinical and demographic parameters such as age, sex, TNM stage, tumor differentiation, risk behavior, Karnofsky Index, duration of operation, and length of hospital stay. Statistics were performed using the Chi-square test or Fisher's exact test for categorical analysis and with the t-test or ANOVA test and Pearson correlation test for continuous variables. Multivariate analysis was computed for BMI with a multivariate linear regression model and for local and medical complications with the multivariate Poisson regression.ResultsIn the sample of 419 OSCC patients, 8.6% were underweight, 54.7% were normal weight, and 36.8% were overweight patients with an overall mean BMI of 24.28 kg/m². BMI was significantly associated with age (p = 0.0017), consumption of nicotine (p = 0.0178) and alcohol (p = 0.0008), dental status (p = 0.0163), tumor differentiation (p = 0.0288), and T-status (p = 0.0005). Underweight patients in particular are negatively correlated with local postoperative complications (p = 0.0047). Local complications are associated with the need for operative revisions (p < 0.0001) and with an increase of the length of hospital stay (p < 0.0001) after multivariable analysis.ConclusionOur results indicate that evaluation of preoperative morbidity and nutritional status, especially in underweight patients, is worthwhile to improve the postoperative outcome after surgical therapy of OSCC patients for medical and economic aspects.



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