Radivojevic, Nemanja (57216412671)Nemanja (57216412671)RadivojevicGrujicic, Sandra Sipetic (56676073300)Sandra Sipetic (56676073300)GrujicicSuljagic, Vesna (6506075339)Vesna (6506075339)SuljagicStojkovic, Stefan (58448712900)Stefan (58448712900)StojkovicArsovic, Konstantin (58782102600)Konstantin (58782102600)ArsovicJakovljevic, Sasa (57455265100)Sasa (57455265100)JakovljevicBukurov, Bojana (55605047500)Bojana (55605047500)BukurovArsovic, Nenad (17033449500)Nenad (17033449500)Arsovic2025-06-122025-06-122025https://doi.org/10.1007/s00405-024-09046-5https://www.scopus.com/inward/record.uri?eid=2-s2.0-85206997637&doi=10.1007%2fs00405-024-09046-5&partnerID=40&md5=3f4a6f6a25aef91dfa5a64fa3d266e81https://remedy.med.bg.ac.rs/handle/123456789/738Background: 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.Laryngeal cancerMalnutritionPostoperative complicationsTotal laryngectomyVitamin D deficiency