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22-04-2024 | Sarcopenia | Review Article

Sarcopenia predicts postoperative complications in head and neck cancer: a systematic review and meta-analysis

Authors: Dan Yang, Lin Su, Liying Zhang, Yu Zhang, Yina Li, Tingxuan Huang, Xiaoli Huang

Published in: European Archives of Oto-Rhino-Laryngology

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Abstract

Purpose

We performed this systematic review and meta-analysis to explore the impact of preoperative sarcopenia on postoperative complication risks after head and neck cancer (HNC) surgery.

Methods

We identified eligible studies by searching Ovid-MEDLINE, Ovid-Embase, EBM Reviews-Cochrane Central Register of Controlled Trials, Web of Science Core Collection, and Scopus. This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance.

Results

Twenty-one studies with a total of 3480 patients met our inclusion criteria. The presence of sarcopenia significantly increased the incidence of overall postoperative complications (OR = 1.72, 95% CI 1.23, 2.41; P = 0.002; I2 = 59%). Subgroup analyses showed a higher risk of postoperative complications in the populations in which sarcopenia was diagnosed with low L3-skeletal muscle index (L3-SMI) or low cross-sectional area of the rectus femoris, but not in the group that sarcopenia was diagnosed with low C3-SMI. Preoperative sarcopenia also substantially increased the risk of severe postoperative complications (OR = 2.26), pharyngocutaneous fistulas (OR = 2.15), free flap-related complications (OR = 1.63), and surgical site infections (OR = 1.84). We also found a tendency toward a higher incidence of wound complications and 30-day mortality in patients with sarcopenia.

Conclusion

Preoperative sarcopenia is a negative prognostic indicator for postoperative complications in patients with HNC after surgery. To reduce the incidence of postoperative complications and improve poor prognosis, further attention needs to be paid to the evaluation and management of preoperative sarcopenia.
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Metadata
Title
Sarcopenia predicts postoperative complications in head and neck cancer: a systematic review and meta-analysis
Authors
Dan Yang
Lin Su
Liying Zhang
Yu Zhang
Yina Li
Tingxuan Huang
Xiaoli Huang
Publication date
22-04-2024
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-024-08577-1