Serum Albumin Levels Pre-Operatively and Post-Operatively As Predications of Wound Healing In Head and Neck Cancer

Wazir Fairoze  Ahmad; Faisal Manzoor; Shahzaib Shaukat; Rao Tahir; Rahat Kalsoom; Hareem Azhar

doi:10.51253/pafmj.v76iSUPPL-8.12042

Authors

Wazir Fairoze Ahmad Department of ENT, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Faisal Manzoor Department of ENT, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Shahzaib Shaukat Department of ENT, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Rao Tahir Department of ENT, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Rahat Kalsoom Department of ENT, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Hareem Azhar Department of ENT, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-8.12042

Keywords:

Hypoalbuminemia; Head and Neck Neoplasms; Serum Albumin, Wound Healing

Abstract

Objective: To determine the serum albumin levels, pre-operatively and post-operatively as predictors of wound healing in head and neck cancer.

Study Design: Prospective analytical study

Place and Duration of Study: Department of ENT, CMH Rawalpindi, Pakistan from Apr 2023 to Sep 2023.

Methodology: Sixty-seven individuals, diagnosed with head and neck squamous cell carcinoma (HNSCC) were included. A week before surgery, blood work including serum albumin levels, and body mass index (BMI, kg/m²) were all assessed. Both males and females between 40-70 years who were diagnosed with carcinoma of the oral cavity and underwent surgical resection, were included, while individuals with chronic liver diseases were excluded from this study.

Results: Of 67 patients 58(86%) were males while 9(14%) were females. The study found a significant association between preoperative and postoperative albumin levels (p<0.001) and wound infection, which shows that patients with serum albumin levels <28 exhibit a higher rate of wound infection compared to those with levels ≥28. Other factors such as diabetes mellitus (p=0.379), cancer stage (0.367), recurrence (p=0.65), and did not show significant associations with postoperative wound infection

Conclusion: Preoperative and postoperative hypoalbuminemia are effective markers representing the onset of severe complications following surgery in head and neck cancer patients.

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References

1. Chow LQ. Head and neck cancer. New Eng J Med 2020; 382(1): 60-72.

2. Konings H, Stappers S, Geens M, De Winter BY, Lamote K, Van Meerbeeck JP et al. A literature review of the potential diagnostic biomarkers of head and neck neoplasms. Front Oncol 2020; 10: 1020.

https://doi.org/10.3389/fonc.2020.01020

3. Loftus TJ, Brown MP, Slish JH, Rosenthal MD. Serum levels of prealbumin and albumin for preoperative risk stratification. Nutr Clin Pract 2019; 34(3): 340-348.

https://doi.org/10.1002/ncp.10271

4. Almasaudi AS, Dolan RD, Edwards CA, McMillan DC. Hypoalbuminemia reflects nutritional risk, body composition and systemic inflammation and is independently associated with survival in patients with colorectal cancer. Cancers 2020; 12(7): 1986. https://doi.org/10.3390/cancers12071986

5. Meyer CP, Rios-Diaz AJ, Dalela D, Ravi P, Sood A, Hanske J et al. The association of hypoalbuminemia with early perioperative outcomes–a comprehensive assessment across 16 major procedures. Am J Surg 2017; 214(5): 871-883. https://doi.org/10.1016/j.amjsurg.2016.11.023

6. Zheng Z, Zhao X, Zhao Q, Zhang Y, Liu S, Liu Z et al. The effects of early nutritional intervention on oral mucositis and nutritional status of patients with head and neck cancer treated with radiotherapy. Front Oncol 2021; 10: 595632.

https://doi.org/10.3389/fonc.2020.595632

7. Brewczyński A, Jabłońska B, Mrowiec S, Składowski K, Rutkowski T. Nutritional support in head and neck radiotherapy patients considering HPV status. Nutrients 2020 ; 13(1): 57.

https://doi.org/10.3390/nu13010057

8. Machiels JP, Leemans CR, Golusinski W, Grau C, Licitra L, Gregoire V. Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx: EHNS–ESMO–ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2020; 31(11): 1462-1475.

https://doi.org/10.1016/j.annonc.2020.07.011

9. Cordeiro LD, Silva TH, de Oliveira LC, Neto JF. Systemic inflammation and nutritional status in patients on palliative cancer care: a systematic review of observational studies. Am J Hosp Palliat Med 2020; 37(7): 565-571. https://doi.org/10.1177/1049909119886833

10. Budach V, Tinhofer I. Novel prognostic clinical factors and biomarkers for outcome prediction in head and neck cancer: a systematic review. Lancet Oncol 2019; 20(6): e313-e326.

https://doi.org/10.1016/S1470-2045(19)30177-9

11. Barsouk A, Aluru JS, Rawla P, Saginala K, Barsouk A. Epidemiology, Risk Factors, and Prevention of Head and Neck Squamous Cell Carcinoma. Med Sci 2023; 11(2): 42. https://doi.org/10.3390/medsci11020042

12. Kuzu MA, Terzioğlu H, Genç V, Erkek AB, Özban M, Sonyürek P et al. Preoperative nutritional risk assessment in predicting postoperative outcome in patients undergoing major surgery. World J Surg 2006; 30: 378-390.

https://doi.org/10.1007/s00268-005-0163-1

13. Gibbs J, Cull W, Henderson W, Daley J, Hur K, Khuri SF. Preoperative serum albumin level as a predictor of operative mortality and morbidity: results from the National VA Surgical Risk Study. Arch Surg 1999 ; 134(1): 36-42.

14. Donaldson M, Bradley PJ. Current management of the nutritional needs of the head and neck cancer patient. Curr Opin Otolaryngol Head Neck Surg 2000; 8(2): 107-112.

15. Cross MB, Yi PH, Thomas CF, Garcia J, Della Valle CJ. Evaluation of malnutrition in orthopaedic surgery. J Am Acad Orthop Surg 2014; 22(3): 193-199.

16. Grammatica A, Piazza C, Paderno A, Taglietti V, Marengoni A, Nicolai P. Free flaps in head and neck reconstruction after oncologic surgery: expected outcomes in the elderly. Otolaryngol Head Neck Surg 2015; 152(5): 796-802.

https://doi.org/10.1177/0194599815576905

17. Lo SL, Yen YH, Lee PJ, Liu CH, Pu CM. Factors influencing postoperative complications in reconstructive microsurgery for head and neck cancer. J Maxillofac Surg 2017; 75(4): 867-873. https://doi.org/10.1016/j.joms.2016.09.025

18. Hoppe IC, Abernathie BL, Datiashvili RO. Examination of possible predictors of complications after free tissue transfer to the head and neck for oncologic defects. Ann Plast Surg 2012; 69(4): 368-370.

19. Danan D, Shonka Jr DC, Selman Y, Chow Z, Smolkin ME, Jameson MJ. Prognostic value of albumin in patients with head and neck cancer. Laryngoscope 2016; 126(7): 1567-1571.

https://doi.org/10.1002/lary.25877

20. Zhang F, Liu X, Tan Z, Li J, Fu D, Zhu L. Effect of postoperative hypoalbuminemia and supplement of human serum albumin on the development of surgical site infection following spinal fusion surgery: a retrospective study. Eur Spine J 2020; 29: 1483-1489. https://doi.org/10.1007/s00586-020-06306-w

21. Lim WS, Roh JL, Kim SB, Choi SH, Nam SY, Kim SY. Pretreatment albumin level predicts survival in head and neck squamous cell carcinoma. Laryngoscope. 2017; 127(12): E437-E442.