Morphomic analysis as an aid for preoperative risk stratification in patients undergoing major head and neck cancer surgery

Jacob Rinkinen; Shailesh Agarwal; Jeff Beauregard; Oluseyi Aliu; Matthew Benedict; Steven R Buchman; Stewart C Wang; Benjamin Levi

doi:10.1016/j.jss.2014.10.002

Morphomic analysis as an aid for preoperative risk stratification in patients undergoing major head and neck cancer surgery

J Surg Res. 2015 Mar;194(1):177-84. doi: 10.1016/j.jss.2014.10.002. Epub 2014 Oct 7.

Authors

Jacob Rinkinen¹, Shailesh Agarwal¹, Jeff Beauregard¹, Oluseyi Aliu¹, Matthew Benedict¹, Steven R Buchman¹, Stewart C Wang¹, Benjamin Levi²

Affiliations

¹ Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan; Department of Biostatistics, University of Michigan, Ann Arbor, Michigan.
² Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan; Department of Biostatistics, University of Michigan, Ann Arbor, Michigan; International Center for Automotive Medicine, Department of Surgery, University of Michigan, Ann Arbor, Michigan. Electronic address: blevi@umich.edu.

Abstract

Background: Patients undergoing major head and neck cancer surgery (MHNCS) may develop significant postoperative complications. To minimize the risk of complications, clinicians often assess multiple measures of preoperative health in terms of medical comorbidities. One emerging method to decrease surgical complications is preoperative assessment of patient frailty measured by specific tissue characteristics. We hypothesize that morphomic characteristics of the temporalis region serve as predictive markers for the development of complications after MHNCS.

Methods: We performed a retrospective review of 69 patients with available computed tomography (CT) imaging who underwent MHNCS from 2006-2012. To measure temporalis region characteristics, we used morphomic analysis of available preoperative CT scans to map out the region. All available CT scans had been performed as part of the patient's routine work-up and were not ordered for morphomic analysis. We describe the correlation among temporalis fat pad volume (TFPV), mean zygomatic arch thickness, and incidence of postoperative complications.

Results: We noted significant difference in the zygomatic bone thickness and TFPV between patients who had medical complications, surgical complications, or total major complications and those who did not. Furthermore, by use of binary logistic regression, our data suggest decreased TFPV and zygomatic arch thickness are stronger predictors of developing postoperative complications than previously studies preoperative characteristics.

Conclusions: We describe morphomic analysis of the temporalis region in patients undergoing MHNCS to identify patients at risk for complications. Regional anatomic morphology may serve as a marker to objectively determine a patient's overall health. Use of the temporalis region is appropriate in patients undergoing MHNCS because of the availability of preoperative scans as part of routine work up for head and/or neck cancer.

Keywords: Head and neck cancer; Morphomics; Outcomes; Temporal fat pad; Zygomatic bone.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Female
Head and Neck Neoplasms / pathology
Head and Neck Neoplasms / surgery*
Humans
Logistic Models
Male
Middle Aged
Postoperative Complications / epidemiology
ROC Curve
Retrospective Studies
Risk
Tomography, X-Ray Computed

Abstract

Publication types

MeSH terms

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