Low Skeletal Muscle Mass as a Key Predictor of Postoperative Diet Outcomes in Circumferential Hypopharyngeal Cancer Reconstruction

OBJECTIVE: To evaluate the association between preoperative lumbar skeletal muscle index (LSMI) and postoperative dietary outcomes (regular diet versus texture-modified diet) in patients undergoing circumferential hypopharyngeal cancer resection with tubed anterolateral thigh flap reconstruction. METHODS: This single-center retrospective cohort study included 73 patients between 2009 and 2020. LSMI was calculated from lumbar skeletal muscle cross-sectional area at the C3 vertebral level on preoperative CT scans. The primary outcome was dietary restriction, defined as Functional Oral Intake Scale ≤ 6 at ≥ 12 months postoperatively. Candidate predictors (pre-, intra- and postoperative) with p < 0.20 in univariate screening underwent theory-driven confounder assessment based on directed acyclic graphs, prior literature, and clinical knowledge. Change-in-estimate criterion (Δβ ≥ 10%) supported selecting confounding. LSMI components (C3CSA, L3CSA, age, sex, weight, height, BMI) were excluded from adjustment to prevent overadjustment for mediators and multicollinearity. The final model analyzed LSMI as a continuous predictor with logistic regression. RESULTS: Fifteen patients (20.5%) developed dietary restriction (FOIS < 7). Three confounders (Eichner A, Stage IV, hemoglobin) for LSMI were identified. Multivariable adjustment improved model fit (AIC: 65.8 → 63.4; Nagelkerke R 2: 0.237 → 0.383) while maintaining statistical significance. Each 1 cm2/m2 increase in LSMI was associated with a 16.1% reduction in the odds of FOIS < 7 (adjusted OR: 0.839; p = 0.006). The optimal LSMI cut-off value was 42.82 cm2/m2. CONCLUSION: Preoperative LSMI independently predicts long-term dietary outcomes after hypopharyngeal reconstruction. Restricting the cohort to uniform resection and reconstruction methods clarified the relationship between skeletal muscle mass and swallowing function, enabling precise risk stratification and supporting targeted prehabilitation interventions. LEVEL OF EVIDENCE: 4.

Abstract aus PubMed (NCBI) für den zitierten Eintrag, in der Originalsprache wiedergegeben. Maßgeblich ist die Fassung der Originalpublikation.

Das Abstract wird nicht übersetzt, damit die eigene Wortwahl der Autoren erhalten bleibt.

In 73 patients undergoing circumferential hypopharyngeal cancer reconstruction with tubed anterolateral thigh flaps, each 1 cm2/m2 higher preoperative lumbar skeletal muscle index was associated with a 16.1% reduction in the odds of long-term dietary restriction (adjusted OR 0.839).

Erfahren Sie, wie diese Forschung mit der klinischen Praxis verknüpft ist

Weitere begutachtete Studien in der Kategorie „Klinische Studien“.

• Leech Therapy for Knee Osteoarthritis — The Landmark RCT — Michalsen et al. (2003)
• Leech-Assisted Flap Salvage — Systematic Review of 277 Cases — Whitaker et al. (2012)
• Auswirkungen der Hirudotherapie auf Leberfunktionen, Lipidprofil und Insulinsensitivität bei Ratten mit metabolischem Syndrom — Bilden A et al. (2026)
• Efficacy and Safety of Hirudotherapy for Improving Sperm Quality Parameters in Male Infertility: A Randomized Controlled Trial — Abtahi-Forooshani M et al. (2026)
• Reverse Sural Flap Venous Congestion Successfully Managed With Enoxaparin in a Male Patient With a Traumatic Foot Crush Injury: A Case Report — Velasco-Bustamante J et al. (2026)
• Investigation of the therapeutic effects of medicinal leech treatment on lower extremity ischemia-reperfusion injury — Ünal K et al. (2026)
• Wirksamkeit der Therapie mit medizinischen Blutegeln bei unterschiedlichen klinischen Anwendungen: Eine umfassende Studie aus Aserbaidschan — Farzali S et al. (2025)
• HIRUDOTHERAPY IN RECONSTRUCTIVE SURGERY: CASE-REPORTS AND REVIEW — Heinz P et al. (2020)
• Hirudotherapy in Wound Healing — Nair H et al. (2022)
• Improvement of patient care through hirudotherapy and the management of leeches from their reception to their disposal in France — Vaesken C et al. (2023)

Alle von der ASH analysierten Studien →