151751-Najiba-Chargi

99 Surgery: skeletal muscle mass and free fibula flap reconstruction Table 1. (Continued) Variables All patients N=78 Low SMM N=48 Without low SMM N=30 p-value Tumor stage (n, %) T1 T2 T3 T4a T4b 1 (1.3) 4 (5.1) 4 (5.1) 67 (85.9) 2 (2.6) 1(2.1) 2(4.2) 1(2.1) 42(87.5) 2(4.2) - 2(6.7) 3(10.0) 25(83.3) - 0.46 Nodal stage (n, %) N0 N1 N2a N2b N2c N3 37 (47.4) 15 (19.2) - 19 (24.4) 7 (9.0) - 21(43.8) 12(25.0) - 10(20.8) 5(10.4) - 16(53.3) 3(10.0) - 9(30.0) 2(6.7) - 0.35 TNM stage (n, %) I II III IV 1 (1.3) 3 (3.8) 3 (3.8) 71 (91.0) 1(2.1) 2(4.2) - 45(93.8) - 1(3.3) 3(10) 26(86.7) 0.10 Localization defect (n, %) Lateral mandible Lateral mandible with hemi- symphysis Lateral mandible with total symphysis Bilateral mandible with total symphysis 30 (38.5) 13 (16.7) 15 (19.2) 17 (21.8) 12(25.0) 8(16.7) 12(25.0) 13(27.1) 18(60.0) 5(16.8) 3(10) 4(13.3) 0.08 Flap ischemic time (M, SD) 2.5 (0.6) 2.45(0.7) 2.6(0.6) 0.26 ** correlation is significant at the 0.01 level (2-tailed) POST-OPERATIVE COMPLICATIONS All postoperative complication are described in table 2. Flap complications occurred in 18 (23.1%) patients, of which 13 (72.2%) occurred in patients with low SMM. Four of these patients finally necessitated flap revision due to vascular congestion or thrombosis and in 1 patient the flap was not salvageable and was lost. In multivariate Cox regression analysis, low SMM was a significant predictive factor for FFF complications (HR 4.3; 95% CI 1.30-14.24; p=0.02) independent of age at time of operation, ACE-27 score, ischemic time and smoking. In total, 61 (78.2%) patients had non-flap related postoperative complications, of which 25 (32.1%) were classified as severe (Clavien-Dindo III-IV), 19 of these patients (67%) had low SMM. Low SMM was also a significant predictive factor for postoperative complications Clavien-Dindo grade III-IV (HR 4.03; 95% CI 1.28 - 12.74 p = 0.02), again independent of age at time of operation, ACE-27 score, ischemic time and smoking. 6