Association of the Preoperative Body Mass Index With Postoperative Complications After Treatment of Oral Squamous Cell Carcinoma

Publication date: August 2018

Source: Journal of Oral and Maxillofacial Surgery, Volume 76, Issue 8

Author(s): Susanne Wolfer, Tatjana Foos, Annika Kunzler, Cornelia Ernst, Stefan Schultze-Mosgau

Purpose

Nutritional status is believed to influence surgical outcome. Because of a lack of actual reports in the literature, this study evaluated 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 Methods

This retrospective cohort study investigated the association between preoperative BMI and surgical outcome for patients with OSCC, focusing on local and medical complications. This research also analyzed common clinical and demographic parameters, such as age, gender, TNM stage, tumor differentiation, risk behavior, Karnofsky Index, duration of operation, and length of hospital stay. Statistics were performed using the χ² test or Fisher exact test for categorical analysis and the t test or analysis of variance 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 multivariate Poisson regression.

Results

In the sample of 419 patients with OSCC, 8.6% were underweight, 54.7% were normal weight, and 36.8% were overweight (overall mean BMI, 24.28 kg/m²). BMI was significantly associated with age (P = .0017), consumption of nicotine (P = .0178) and alcohol (P = .0008), dental status (P = .0163), tumor differentiation (P = .0288), and tumor status (P = .0005). Underweight in particular was negatively correlated with local postoperative complications (P = .0047). Local complications were associated with the need for operative revisions (P < .0001) and an increase of hospital length of stay (P < .0001) using multivariable analysis.

Conclusion

These results indicate that evaluation of preoperative morbidity and nutritional status, especially in underweight patients, is worthwhile to improve medical and economic postoperative outcomes after surgical therapy of OSCC.

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