Nutritional Factors and Survival in a Cohort of Patients with Oral Cancer

Background: Malnutrition commonly affects patients with oral squamous cell carcinoma (OSCC), which contributes to worsening prognosis. Moreover, specific strategies for diagnosing and managing malnutrition in OSCC are lacking. Methods: This retrospective study included 52 consecutive patients with OSCC who underwent surgery at the University Hospital of Palermo (I) from Jan 2020 to May 2023. In-hospital nutritional support was provided by a dedicated team. The patients were compared with a historical control group of 11 patients. The nutritional treatment consisted of standard oral (ON) or artificial nutrition (AN). Traditional measurements, including bioimpedance-derived body composition and volumetric reconstruction of the posterior paraspinal muscles at the C3 level based on magnetic resonance imaging (MRI-C3), were obtained in 16 patients to investigate sarcopenia. Results: The patients were categorized according to TNM stage: groups A (TNM stages I-III) and B (IVa-IVc). The prevalence of group A patients was 59.6% in the case group and 90.9% in the control group (P<0.001). The patients with advanced stages of OSCC (log-rank test, P<0.001) and those receiving AN treatment (P<0.001) had lower survival rates. The 3-12 month post-surgery MRI_C3 increased in the patients who received ON treatment and decreased in those who received AN treatment (P<0.001). Conclusions: Nutritional factors significantly affect the survival of patients with OSCC. The MRI-C3 measurement of paravertebral muscles is a promising technique for detecting sarcopenia.