Calf circumference is an independent predictor of postoperative complications in the surgical treatment of head and neck cance

Main Article Content

Neyara dos Santos Oliveira
Tercio Guimarães Reis
Adriele Luana Carneiro
Suzane Pereira Souza
Maurício Gomes da Silva Serra
José de Bessa Júnior
Márcio Campos Oliveira

Abstract

Introduction: The prevalence of malnutrition is high among head and neck cancer (HNC) patients and negatively impacts their quality of life, treatment, and survival rates. Objective: To identify preoperative nutritional variables capable of predicting postoperative complications in surgically treated HNC patients. Methods: This was a prospective cohort study of HNC patients referred for surgery as initial treatment. Results: Sixty patients were included in the study; they had a median age of 65.5 years, were mostly men (85%), and most had low education levels (90%) and low household income (78.3%). The incidence rate of severe postoperative complications (grades II, III, IV, and V according to the Clavien-Dindo grading system) was found to be 50%. The nutritional variables under investigation, namely calf circumference (CC), triceps skinfold, body mass index, and adductor pollicis muscle thickness were shown to predict postoperative complications in HNC patients, especially CC, which was found to be an independent predictor of complications (OR=0.8; 95%CI: 0.65–0.96). Each 1-cm increase in calf circumference was associated with a 20% decrease in the risk of postoperative complications. Conclusion: Our findings show the nutritional variables studied are useful in the prognostic assessment of HNC surgery.

Downloads

Download data is not yet available.

Article Details

How to Cite
Oliveira, N. dos S., Reis, T. G., Carneiro, A. L., Souza, S. P., Serra, M. G. da S., Bessa Júnior, J. de ., & Oliveira, M. C. (2022). Calf circumference is an independent predictor of postoperative complications in the surgical treatment of head and neck cance. ABCS Health Sciences, 47, e022232. https://doi.org/10.7322/abcshs.2020237.1666
Section
Original Articles
Author Biographies

Neyara dos Santos Oliveira, Departamento de Saúde Pública e Epidemiologia, Universidade Estadual de Feira de Santana (UEFS) – Feira de Santana (BA), Brazil /Núcleo de Pesquisa em Câncer de Cabeça e Pescoço (NUPESCAP) – Feira de Santana (BA), Brazil

Head and Neck Cancer Research Group - NUPESCAP

Tercio Guimarães Reis, Núcleo de Pesquisa em Câncer de Cabeça e Pescoço (NUPESCAP) – Feira de Santana (BA), Brazil /Santa Casa de Misericórdia de Feira de Santana (SCMFS) – Feira de Santana (BA), Brazil

Santa Casa de Misricórdia de Feira de Santana

References

Haghjoo SH. Malnutrition associated with head and neck cancers. Rev Clin Med. 2015;2(2):76-9. https://doi.org/10.17463/RCM.2015.02.005

Oliveira FP, Santos A, Viana MS, Alves JL, Pinho NB, Reis PF. Perfil nutricional de pacientes com câncer de cavidade oral em pré-tratamento antineoplásico. Rev Bras Cancerol. 2015;61(3):253-9.

Talway B, Donnally R, Skally R, Donaldson M. Nutritional management in head and neck cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol. 2016;130(2):32-40. https://doi.org/10.1017/S0022215116000402

Saroul N, Pastourel R, Mulliez A, Farigon N, Dupuch V, Mom T, et al. Which Assessment Method of Malnutrition in Head and Neck Cancer? Otolaryngol Head Neck Surg. 2018;158(6):1065-71. https://doi.org/10.1177/0194599818755995

Leung JSL, Seto A, Li GKH. Association Between Preoperative Nutritional Status and Postoperative Outcome in Head and Neck Cancer Patients. Nutr Cancer. 2017;69(3):464-9. https://doi.org/10.1080/01635581.2017.1285406

Acuña K, Cruz T. Avaliação do estado nutricional de adultos e idosos e situação nutricional da população brasileira. Arq Bras Endocrinol Metab. 2004;48(3):345-61. https://doi.org/10.1590/S0004-27302004000300004

Union for Internacional Cancer Control (UICC). TNM: classificação de tumores malignos. 8th edition. 2017.

Charlson ME, Pompei P, Ales KL, Mackenzie CR. A new method of classifying prognostic comorbity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-83. https://doi.org/10.1016/0021-9681(87)90171-8

American Society of Anesthesiologists (ASA). ASA Physical Status Classification System. Washington: ASA, 2014.

Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. Human Kinetics, 1988; p.1-124.

Bailey KV, Ferro-Luzzi A. Use of body mass index of adults in assessing individual and community nutritional status. Bull World Health Organ. 1995;73(5):673-80.

Lameu EB, Gerude MF, Corrêa RC, Lima KA. Adductor pollicis muscle: a new anthropometric parameter. Rev Hosp Clin Fac Med. 2004;59(2):57-62. http://dx.doi.org/10.1590/S0041-87812004000200002

Moreira LF, Pessôa MCM, Mattana DS, Smithz FF, Volkwei BS, Antoniazzi JL, et al. Adaptação cultural e teste da escala de complicações cirúrgicas de Clavien-Dindo traduzida para o português do Brasil. Rev Col Bras Cir. 2016;43(3):141-8. https://doi.org/10.1590/0100-69912016003001

Brasil. Ministério da Saúde. Instituto Nacional do Câncer José Alencar Gomes da Silva. Estimativa 2018: Incidência de Câncer no Brasil. INCA, 2018.

Maasland DHE, van den Brant PA, Kremer B, Goldnohm RAS, Shouten LJ. Alcohol consumption, cigarette smoking and the risk of subtypes of head-neck cancer: results from the Netherlands Cohort Study. BMC Cancer. 2014;14:187. https://doi.org/10.1186/1471-2407-14-187

Son HJ, Roh JL, Nan SY, KIM SY. Nutritional and hematologic markers as predictors of risk of surgical site infection in patients with head and neck cancer undergoing major oncologic surgery. Head Neck. 2017;40(3):596-604. https://doi.org/10.1002/hed.25031

Organização Pan-Americana (OPAS). XXXVI Reunión del Comitê Asesor de Ivestigaciones em Salud (CAIS). Encuestra Multicêntrica. Salud Beinestar yEnvejecimeiento (SABE) en América Latina e el Caribe. Washington: 2002.

Melo ILP, Dantas MAM, Silva LC, Lima VT, Lima SCVC, Sena KCM. Avaliação nutricional de pacientes cirúrgicos com câncer de cabeça e pescoço sob terapia nutricional enteral. Rev Bras Nutr Clin. 2006;21(1):6-11.

Gama RR, Song Y, Zang Q, Brown MC, Wang J, Habbous S, et al. Body mass index and prognosis in patients with head and neck cancer. Head Neck. 2017;39(6):1226-33. https://doi.org/10.1002/hed.24760

Karnell LA, Sperry SM, Anderson CM, Pegedar NA. Influence of body composition on survival in patients with head and neck cancer. Head Neck. 2015;38(Suppl.1):E261-7. https://doi.org/10.1002/hed.23983

Silver HJ, Guimarães CCG, Pedruzzi P, Badia M, Carvalho AS, Oliveira BV, et al. Predictors of functional decline in locally advanced head and neck cancer patients from south Brazil. Head Neck. 2010;32(9):1217-25. https://doi.org/10.1002/hed.21322

Bragagnolo R, Caporossi FS, Dock-Nascimento DB, Aguilar-Nascimento JE. Espessura do músculo adutor do polegar: um método rápido e confiável na avaliação nutricional de pacientes cirúrgicos. Rev Col Bras Cir. 2009;36(5):371-6. http://dx.doi.org/10.1590/S0100-69912009000500003

Mello FS, Waisberg J, Silva MLN. Calf circumference is associated with the worst clinical outcome in elderly patients. Geriatr Gerontol Aging. 2016;10(2):80-5.

Gonzalez MC, Duarte RRP, Orlandi SP, Bielemann RM, Barbosa-Silva TG. Adductor pollicis muscle: A study about its use as a nutritional parameter in surgical patients. Clin Nutr. 2015;34(5):1025-9. https://doi.org/10.1016/j.clnu.2014.11.006

Rosa TCA, Arakaki DG, Arruda ECF, Rodrigues AS, Raslan M, Freitas KC. Adductor pollicis muscle: potential anthropometric parameter in hospitalized individuals. Acta Sci Health Sci. 2015;37(2):111-17. https://doi.org/10.4025/actascihealthsci.v37i2.25990

Luís DA, Terroba MC, Cuellar L, Izaola O, de la Fuente B, Martin T, et al. Association of anthropometric and biochemical markers with length of stay and mortality in the hospital. Eur Rev Med Pharmacol Sci. 2013;17(10):1321-5.