Rethinking Risk in Glossectomy: Obesity and Overweight Status Linked to Fewer Complications and Shorter Hospital...

Area of Science:

• Surgical oncology
• Metabolic research
• Patient outcomes

Background:

• The obesity paradox, where higher body mass index (BMI) correlates with better surgical outcomes, is a recognized phenomenon.
• However, its applicability to glossectomy, a surgery for tongue cancer, remains unexplored.

Purpose of the Study:

• To investigate the relationship between BMI and surgical outcomes in patients undergoing glossectomy.
• To determine if an obesity paradox exists in this patient population.

Main Methods:

• A retrospective cohort study analyzed 6816 patients who underwent partial or total glossectomy between 2006 and 2022.
• Patients were stratified by BMI, and outcomes such as operative time, length of stay (LOS), readmission rates, and complications were assessed.
• Statistical analyses included univariate and multivariable models to adjust for confounding factors.

Main Results:

• Obese patients (30.8%) demonstrated the shortest LOS (1 day) and lowest complication rates (11.7%).
• Underweight patients (4.0%) faced the longest operative times (393 min), longest LOS (8 days), and highest complication rates (35.9%).
• Multivariable analysis confirmed that higher BMI (overweight/obese) was associated with shorter LOS and reduced odds of complications, while underweight BMI independently predicted poorer outcomes.

Conclusions:

• The study findings support the existence of an obesity paradox in glossectomy.
• The observed paradox appears to be driven by the increased vulnerability of underweight patients rather than a protective effect conferred by higher adiposity.