Abstract

Objective. Major head and neck surgeries are associated with significant perioperative morbidity. Despite extensive metabolic parameter investigations, consistent prognostic indicators remain undefined. 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 demonstrated 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.

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‪Eyal Yosefof‬‏ - Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petach-Tikva, Israel; Institute of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. EY and YS contributed equally to the work. Corresponding author - eyalyos@gmail.com

Yoni Shopen - Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petach-Tikva, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. EY and YS contributed equally to the work.

Ofir Zavdy - Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petach-Tikva, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Noga Kurman - nstitute of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Pierre Singer - Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Petach Tikva, Israel

Moshe Yehuda - Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petach-Tikva, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Thomas Shpitzer - Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petach-Tikva, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Aviram Mizrachi - Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petach-Tikva, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Gideon Bachar - Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petach-Tikva, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Sharon Tzelnick - Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petach-Tikva, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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Copyright (c) 2026 Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale

How to Cite
Yosefof‬‏, ‪Eyal, Shopen, Y., Zavdy, O., Kurman, N., Singer, P. ., Yehuda, M. ., Shpitzer, T., Mizrachi, A., Bachar, G., & Tzelnick, S. (2026). The prognostic impact of perioperative metabolic variables in head and neck cancer: a prospective study. ACTA Otorhinolaryngologica Italica, 46(1), 34–42. https://doi.org/10.14639/0392-100X-A836
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