Browsing by Author "Arsovic, Konstantin (58782102600)"

Background: Postoperative complications (PCs) following total laryngectomy remain a significant challenge, with recent investigations directed toward the impact of nutrition status and vitamin D deficiency. Objectives: To elucidate the association between preoperative vitamin D level status, malnutrition risk score, and surgical and survival outcomes in patients with advanced laryngeal cancer following total laryngectomy. Study design: Prospective cohort study. Methods: Sixty-four patients with advanced laryngeal carcinoma treated with total laryngectomy were included in the study. Serum levels of 25(OH) D3 were measured employing a commercial chemiluminescent immunoassay kit, while nutrition status was evaluated using the nutrition risk index (NRI) and Malnutrition universal screening tool (MUST). Results: The mean serum 25(OH) D level was 37.1 ± 19.4 nmol/L (range 11.0-100.6 nmol/L), with 47% of patients exhibiting vitamin D deficiency and 31% displaying insufficiency. Medium/high MUST score had 53% of patients, and moderate/severe NRI was verified in 48% of patients. Univariate logistic regression analysis identified MUST score, GPS score, neutrophil-to-lymphocyte ratio, and circulating 25(OH) D levels as predictive for the occurrence of PCs. In multivariate analysis, MUST score and circulating 25(OH) D levels remained significantly associated with PCs. Patients with high nutrition risk had significantly lower two-year OS rates compared to the medium and low nutrition risk groups, respectively (30% vs. 62% and 83%, p = 0.010). Conclusion: Early identification of malnourished or patients with vitamin D deficiency and those who would benefit from specific nutritional support could be beneficial for minimizing the risk of development of surgical complications and help improve our clinical outcomes. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.

To determine the prognostic value of tumor volume in predicting the survival in patients with stage III–IV of hypopharyngeal carcinoma. We studied 71 patients with advanced stage of hypopharyngeal carcinoma. The volume of primary tumor was calculated by approximation of the ellipsoid volume. Correlation between carcinoma volume and demographic, clinical and carcinoma characteristics has shown that male patients and patients consuming alcohol had greater tumor volumes. The median of overall survival was at 12 months (95% CI: 9.25–14.75); the median of progression-free survival was at 9 months (95% CI: 6.6–11.3). ROC Curve Analysis of carcinoma volumes in outcome prediction shows that the cutoff of 14.69 had the sensitivity of 61% and specifics of 89%. Based on significant independent impact of tumor volume on survival, it is important to include this parameter among possible new treatment protocols. © Association of Otolaryngologists of India 2024.