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Head Neck. 2018 May;40(5):1057-1067. doi: 10.1002/hed.25072. Epub 2018 Jan 24.

Effect of preoperative immunonutrition on postoperative short-term outcomes of patients with head and neck squamous cell carcinoma.

Author information

1
Department of Diabetes, Endocrinology, Clinical Nutrition and Metabolism, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
2
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
3
Department of Endocrinology, Diabetes and Clinical Nutrition, University Department of Internal Medicine, Kantonsspital Aarau, Switzerland.

Abstract

BACKGROUND:

Patients with head and neck squamous cell carcinoma (HNSCC) often acquire an impaired nutritional status resulting in compromised outcomes. Perioperative immunonutrition may have a positive effect on outcomes after elective surgery.

METHODS:

Short-term outcomes before and after implementation of preoperative immunonutrition were retrospectively assessed. Regression models adjusted for outcome predictors were used to compare the length of stay (LOS) in the hospital, local infections, and general complications.

RESULTS:

Four hundred eleven patients were included (control group = 209 and the intervention group = 202). With immunonutrition, hospital LOS was significantly lower (median 6 vs 8 days; adjusted mean difference of -5.65 days; P < .001) and local infections were significantly reduced (7.4% vs 15.3%; adjusted odds ratio [OR] 0.30; P = .006). Subgroup analysis showed more pronounced effects in patients with previous radiotherapy and extensive surgery.

CONCLUSION:

Patients receiving preoperative immunonutrition had a shorter hospital LOS and a lower rate for wound infections and local complications. These effects remained robust after a multivariate adjustment.

KEYWORDS:

head and neck cancer; head and neck surgery; immunonutrition; length of hospital stay; wound infections

PMID:
29368455
DOI:
10.1002/hed.25072

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