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151 Surgery: skeletal muscle mass and oral cavity cancer severity. Several studies showed that comorbidities are a reliable predictor for perioperative complications and that the ASA classification and ACE-27 index can both accurately measure comorbidities. 35–39 We used Slice-O-Matic to identify skeletal muscle fromMRI and CT scans. These two different imaging modalities show significant correlation in quantifying SMI when measured by CSA at the level of C3. 19 The excellent inter-observer agreement for SMI measurement at the level of C3 should allow SMI measurements findings to be used globally to select patients for suitable therapy. We defined sarcopenia as the lowest quartile LSMI of the patient group, because there is no cut-off value for the definition of sarcopenia. 3132 This means that a method to measure sarco- penia in the clinical setting and a clear definition of sarcopenia is needed. By the European Working Group on Sarcopenia in Older People (EWGSOP) sarcopenia is de - scribed as a generalized and progressive loss of muscle function and skeletal muscle mass caused by adversemuscle changes that accrue during lifetime. 2 Due to its retrospective design, we could only use the skeletal muscle mass at a single point of time as measured on routinely preformed CT or MRI to define sarcopenia, since skeletal muscle mass of earlier time points could not be measured. Since the prevalence of perioperative complications was low with 51 patients with perioper- ative complications out of 226 patients (22.6%), the retrospective cohort design of our study results in more controls than cases. Therefore, a case-controlled setting would be preferred. Also because of the retrospective cohort design, further research is warranted. Our finding that sarcopenia is associated with perioperative complication rate may help sur - geons to anticipate on the risk of perioperative complications. A method to measure sarco - penia in the clinical setting and a clear definition of sarcopenia is needed, as well as studies on the management of sarcopenia in the pre-operative stage. CONCLUSION Within the limitations of this study, wemay conclude that sarcopenia, among other well-known factors, is associated with perioperative complication rate. 8