Nutritional Status and Outcomes Following Open Laryngeal Surgery for Laryngeal Cancer: A NSQIP Database Study

Area of Science:

• Oncology
• Surgical Outcomes
• Nutritional Science

Background:

• Malnutrition and weight loss in laryngeal cancer patients negatively impact immune function and wound healing.
• Understanding the effects of underweight status on perioperative outcomes is vital for enhancing patient care.

Purpose of the Study:

• To evaluate the perioperative outcomes of patients undergoing laryngectomy for laryngeal cancer.
• To specifically assess the impact of underweight status and recent unintentional weight loss on surgical outcomes.

Main Methods:

• Retrospective cohort study utilizing the American College of Surgeons National Surgical Quality Improvement Program database.
• Inclusion criteria: patients undergoing open total or partial laryngectomies for cancer with underweight (BMI < 18.5) or normal weight (BMI 18.5-29.9) BMIs.
• Statistical analysis included univariate and multivariate analyses with significance set at p < 0.05.

Main Results:

• Underweight patients (n=276) had significantly higher rates of medical complications (p<0.001), longer hospital stays (p<0.001), wound disruptions (p=0.002), and greater transfusion needs (p<0.001) compared to normal-weight patients (n=1736).
• In a subgroup of patients with recent unintentional weight loss, underweight individuals showed increased risk for medical complications (p=0.046) and transfusion requirements (p<0.001).
• No significant difference in wound disruptions or length of stay was observed in the weight-loss subgroup.

Conclusions:

• Underweight status and recent unintentional weight loss are associated with increased perioperative medical complications and transfusion requirements in laryngeal cancer patients undergoing laryngectomy.
• Preoperative nutritional optimization may be beneficial for improving surgical recovery and overall outcomes in at-risk patients.