Effect of preoperative immunonutrition on complications after salvage surgery in head and neck cancer.

Müller, Simon Andreas; Mayer, Catherine; Bojaxhiu, Beat; Aeberhard, Carla; Schuetz, Philipp; Stanga, Zeno; Giger, Roland (2019). Effect of preoperative immunonutrition on complications after salvage surgery in head and neck cancer. Journal of otolaryngology, head & neck surgery, 48(1), p. 25. BioMed Central 10.1186/s40463-019-0345-8

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BACKGROUND

Patients undergoing salvage surgery for recurrent head and neck squamous cell carcinoma are at high risk of postoperative complications due to the adverse effects of radiotherapy on wound healing. Malnutrition is an additional risk factor and we tested the hypothesis that preoperative administration of immunonutrition would decrease complications in this high risk population.

METHODS

This single armed study with historical control included consecutive patients undergoing salvage surgery for recurrent head and neck squamous cell carcinoma. We compared outcomes before and after implementation of preoperative immunonutrition and adjusted the regression analysis for gender, age, body mass index, Nutritional Risk Screening (NRS 2002), tobacco and alcohol consumption, tumor localization, tumor stage, and type of surgery. The primary endpoint was overall complications from surgery within a follow-up of 30 days.

RESULTS

Ninety-six patients were included (intervention group: 51, control group: 45). Use of preoperative immunonutrition was associated with a significant reduction in overall complications (35% vs. 58%, fully-adjusted odds ratio 0.30 (95%CI 0.10-0.91, p = 0.034). Length of hospital stay was also significantly reduced (17 days vs. 6 days, p = < 0.001). No differences in mortality and hospital readmission were found. These results remained robust in multivariate analysis.

CONCLUSIONS

In patients undergoing salvage surgery for recurrent head and neck squamous cell carcinoma, preoperative immunonutrition exhibited favorable effects on the complication rate and consequently reduced the length of hospital stay. By improving both tissue regeneration and immune response, immunonutrition may help to improve surgical outcomes in this high-risk population.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition

UniBE Contributor:

Müller, Simon Andreas; Bojaxhiu, Beat; Stanga-Nodari, Zeno and Giger, Roland

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1916-0216

Publisher:

BioMed Central

Language:

English

Submitter:

Beatrice Scheidegger

Date Deposited:

27 Jun 2019 11:23

Last Modified:

09 Apr 2020 08:34

Publisher DOI:

10.1186/s40463-019-0345-8

PubMed ID:

31151486

Uncontrolled Keywords:

Head and neck cancer Immunonutrition Operative complications Radiotherapy Salvage surgery

BORIS DOI:

10.7892/boris.131362

URI:

https://boris.unibe.ch/id/eprint/131362

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