Achim V, et al. - This study entailed the determination of the incidence of sarcopenia in patients with squamous cell carcinoma (SCC) undergoing total laryngectomy (TL). Researchers also sought to examine its association with the development of postoperative wound complications. The results disclosed that sarcopenia served as an independent negative prognostic indicator for the development of all complications and wound complications after TL for the treatment of SCC.

Methods

• The plot of this study was a retrospective medical chart review.
• The enrollment consisted of 70 patients with SCC who underwent TL with cross-sectional abdominal imaging obtained preoperatively from 2004 to 2016 in a tertiary care hospital.
• Herein, patients were determined to have sarcopenia present if the skeletal muscle index was estimated to be less than 38.5 cm²/m² for women and 52.4 cm²/m² for men.
• Demographic data comprised of age, sex, smoking history, Charlson Comorbidity Index (CCI) score, prior radiation history, tumor stage, body mass index (BMI), and preoperative albumin levels.
• During this study, measurements of abdominal wall and paraspinal musculature at the cross-sectional L3 vertebral body were carried out, normalized for height, and compared with previously defined sex-specific cutoff values in order to detect sarcopenia.
• A detemination was conducted of the postoperative complications including all complications, wound-related complications, and pharyngo-cutaneous fistula (PCF).

Results

• In 54 (77%) patients, sarcopenia was detected preoperatively.
• No prominent variation was discovered between the sarcopenia group and the nonsarcopenia group for any data, with the exception of BMI (Cohen d = 1; 95% CI, 0.41-1.57) and preoperative albumin levels (Cohen d = 0.69; 95% CI, 0.11-1.25).
• Among 70 patients, the development of a PCF was noted in 13 (24%) in the sarcopenia group compared with 0 (0%) without sarcopenia (OR, 1.32; 95% CI, 1.13-1.53).
• Likewise, 35 (50%) patients in the sarcopenia group developed a wound complication compared with 2 (13%) in the nonsarcopenia group (OR, 7.54; 95% CI, 1.56-36.4).
• Sarcopenia was revealed to be the only predictive factor of any complication (OR, 6.53; 95% CI, 1.84-23.23) and any wound complication (OR, 7.54; 95% CI, 1.56-36.4), in the univariate analysis.
• It was determined that only sarcopenia served as a prominent predictor for all complications (OR, 7.96; 95% CI, 1.39-45.29), as illustrated by the multivariable analysis of preoperative albumin levels and preoperative sarcopenia.