The prognostic impact of perioperative metabolic variables in head and neck cancer: a prospective study

Objective. Major head and neck surgeries are associated with significant perioperative morbidity. Despite extensive metabolic parameter investigations, consistent prognostic indicators remain un-defined. This study aimed to elucidate metabolic predictors for perioperative prognosis. Methods. A prospective observational study evaluated patients undergoing major head and neck surgeries (2019-2020). Nutritional status was assessed preoperatively and on postoperative days 2 and 10 using electric bioimpedance analysis. Phase angle, a bioelectrical marker of soft-tissue mass and hydration, served as a nutritional status indicator. Results. 37 patients were included (mean age 61.3 ± 12.5 years; 45.9% males), predominantly with oral cavity origins (75.7%). Postoperative day 10 phase angle significantly correlated with one-year survival (p = 0.014). Neutrophil-to-lymphocyte ratio (NLR) on postoperative days 2 and 10 was associated with postoperative complications (p = 0.022 and 0.026). Preoperative nutritional support demon-strated improved phase angle, optimised NLR levels, and reduced risk of complications (p = 0.023). Conclusions. Phase angle represents a significant prognostic indicator for survival of head and neck surgical patients. Preoperative nutritional intervention shows potential in reducing complications and enhancing post-surgical metabolic outcomes.