The prognostic impact of perioperative metabolic variables in head and neck cancer: a prospective study.

OBJECTIVE

Major head and neck surgeries are associated with significant perioperative morbidity. Despite extensive metabolic parameter investigations, consistent prognostic indicators remain undefined. This study aimed to elucidate metabolic predictors for perioperative prognosis.

METHODS

A prospective observational study evaluated patients undergoing major head and neck surgeries (2019-2020). Nutritional status was assessed preoperatively and on postoperative days 2 and 10 using electric bioimpedance analysis. Phase angle, a bioelectrical marker of soft-tissue mass and hydration, served as a nutritional status indicator.

RESULTS

37 patients were included (mean age 61.3 ± 12.5 years; 45.9% males), predominantly with oral cavity origins (75.7%). Postoperative day 10 phase angle significantly correlated with one-year survival (p = 0.014). Neutrophil-to-lymphocyte ratio (NLR) on postoperative days 2 and 10 was associated with postoperative complications (p = 0.022 and 0.026). Preoperative nutritional support demonstrated improved phase angle, optimised NLR levels, and reduced risk of complications (p = 0.023).

CONCLUSIONS

Phase angle represents a significant prognostic indicator for survival of head and neck surgical patients. Preoperative nutritional intervention shows potential in reducing complications and enhancing post-surgical metabolic outcomes.