What Factors Affect Changes in Body Composition and Swallowing Function in Patients Hospitalized for Oral Cancer Surgery?
Received 18 October 2019
Accepted for publication 11 December 2019
Published 6 January 2020 Volume 2020:15 Pages 1—7
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Richard Walker
Yuko Kagifuku,1 Haruka Tohara,1 Yoko Wakasugi,1 Chiaki Susa,1 Ayako Nakane,1 Mizue Toyoshima,2 Koichi Nakakuki,3 Yuji Kabasawa,4 Hiroyuki Harada,5 Shunsuke Minakuchi1
1Department of Gerontology and Gerodontology, Division of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; 2Section of Nutrition Management, Tokyo Medical and Dental University Dental Hospital, Tokyo, Japan; 3Department of Maxillofacial Surgery, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; 4Department of Oral Care for Systemic Health Support, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan; 5Department of Oral and Maxillofacial Surgery, Oral Restitution, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
Correspondence: Haruka Tohara
Department of Gerontology and Gerodontology, Division of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
Purpose: There are few studies about sarcopenia before and after surgery for oral cancer. Therefore, we examined body composition during hospitalization and factors affecting weight loss, skeletal muscle mass index (SMI) reduction, and swallowing function at discharge in this patient group.
Patients and Methods: A prospective survey was conducted at Tokyo Medical and Dental University Dental Hospital for patients who underwent primary surgery for oral cancer and reconstruction using free flaps. We compared body weight, SMI, grip strength, and walking speed at admission and discharge. We also examined factors affecting weight loss and SMI reduction and the functional oral intake scale (FOIS) score at discharge.
Results: There were 26 patients that we could survey during the period. As a result of Wilcoxon’s signed-rank test, body weight, SMI, and grip strength were significantly reduced during hospitalization, but no reduction was noted for sarcopenia. As a result of multiple regression analysis, postoperative chemoradiotherapy was a risk factor for weight loss, reduced SMI, and low FOIS score at discharge.
Conclusion: Postoperative chemoradiotherapy is a risk factor for weight loss, muscle mass loss, and dysphagia at discharge, and chemoradiotherapy may affect rather than an invasion of surgery. After surgery, besides follow-ups for cancer, oral cancer patients should be followed up to assess dysphagia, undernutrition, and sarcopenia.
Keywords: sarcopenia, chemoradiotherapy, dysphagia, head and neck cancer
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