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Perioperative Immunonutrition and Postoperative Recovery Patterns in Oral Squamous Cell Carcinoma Surgery: A
F Ferragina1, Y Ferro2, I Barca1
1Department of Experimental and Clinical Medicine Magna Graecia University Catanzaro Italy unicz.it.
Background:
Malnutrition and sarcopenia negatively affect outcomes in patients undergoing surgery for oral squamous cell carcinoma (OSCC). Immunonutrition has been proposed to improve perioperative recovery, but evidence remains limited, particularly in oral cancer surgery. The objective of this study was to evaluate postoperative weight changes, muscle status, complications, and hospital stay in patients with OSCC who received a perioperative immune-nutritional protocol.
Methods:
We conducted a single-center prospective observational cohort study including 22 patients surgically treated for OSCC between January 2022 and January 2024. All patients received perioperative immunonutrition administered orally or via nasogastric tube at four timepoints (T0: preoperative; T1: immediate postoperative; T2: discharge; T3: 30 days). All patients underwent anthropometric measurements, muscle strength assessment, and bioelectrical impedance analysis (muscle mass, phase angle, and total body water). All evaluations were performed at each study timepoint.
Results:
The study population consisted of 62% females, with a mean age of 65 ± 10 years, and 17% of patients presented clinically relevant nutritional risk at baseline. Patients experienced a mean weight loss of 2.1 kg during the early postoperative hospitalization period, followed by a partial recovery of 1.2 kg within 30 days (p < 0.001). Phase angle and handgrip strength remained stable throughout the follow-up, indicating preserved cellular integrity and muscle function. Wound dehiscence occurred in 38% but healed without major sequelae. The average length of hospital stay was 13.8 ± 6.9 days. Although the results are lower than those reported in the literature on similar OSCC cases, caution is warranted when comparing due to differences in design and perioperative management.
Conclusions:
In patients undergoing surgery for OSCC, the perioperative immune-nutritional protocol was associated with minimal postoperative weight loss and stable functional muscle status. Additionally, the postoperative recovery patterns in this cohort were favorable, and the complication rates were low.
Clinical Implications:
Integrating immunonutrition into enhanced recovery (ERAS) pathways may optimize surgical outcomes, reduce hospitalization costs, and improve patient quality of life.