151751-Najiba-Chargi

112 CHAPTER 7 ABSTRACT Background Low skeletal muscle mass (SMM) and systematic inflammation are associated with post-op - erative morbidity and survival. Materials and methods Patients undergoingmicrovascular free flap head and neck (HN) reconstructionwere included. SMMwas measured on imaging. Inflammationwas evaluated by the neutrophil-to-lymphocyte ratio (NLR). Post-operative complications, date of recurrence and death were scored. Results 616 patients were included. Non-flap and flap-related complications occurred in 39.3% and 12.3%, respectively. Flap-failure rate was 4.7%. For oncological cases, predictors for compli - cations were elevated NLR in all flap surgery (OR 1.5), low SMM in radial forearm flap surgery (OR 2.1) and elevated NLR combined with low SMM in fibula flap surgery (OR 5.2). Patients with solely elevated NLR were at significant risk for flap-related complications (OR 3.0), severe complications (OR 2.2) and when combined with low SMM for increased length of hospital stays (LOS) (+3.9 days). In early-stage HN squamous cell carcinoma (HNSCC), low SMM (HR 2.3) and combined elevated NLR with low SMM (HR 2.3) were prognostics for overall survival (OS) and age for disease free survival (DFS) (HR 1.1). In advanced-stage HNSCC, hemoglobin (HR 0.99) and body-mass index (HR 0.94) were prognostics for OS and hemoglobin (HR 0.99) for DFS. Conclusion SMM and NLR are predictive for complications and increased LOS in microvascular free flap HN reconstruction. Also, SMM and NLR have prognostic impact for OS in early stage HNSCC. SMM and NLR are routinely available and may aid the clinician in the identification of patients at risk of a poor outcome.