Sarcopenia negatively affects oncologic outcomes. However, studies have yet to reveal whether it is associated with postoperative complications and survival among patients with oral cavity squamous cell carcinoma (OSCC). This study retrospectively enrolled 592 patients undergoing primary OSCC surgery with available computed tomography (CT) images of their third cervical vertebrae (C3) within 30 days before surgery between January 2011 and December 2020. Preoperative sarcopenia, nutritional and frailty status, tumor characteristics, comorbidities, and inflammatory markers were assessed. The outcome variables included 30-day complications based on the Buzby and Dindo classification, reoperation, 5- and 8-year overall survival, and disease-free survival. A total of 318 (53.7%) had sarcopenia; of these patients, 217 (68.2%) presented with postoperative complications, and 48 (15.1%) underwent reoperations. Sarcopenia and higher systemic immune-inflammatory index were independently associated with local to systemic 30-day complications. Sarcopenia, advanced-stage disease, and extracapsular spread were correlated with 5- and 8-year survival. The presence of sarcopenia is associated with the 30-day complications and short- and long-term survival of patients who had OSCC and underwent surgery.

In this study, we aimed to evaluate the prognostic impact of sarcopenia, five-item modified frailty index (mFI-5), neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) in patients with oral cavity squamous cell carcinoma (OSCC) treated with adjuvant chemoradiotherapy (CRT) and their survival outcomes. We retrospectively enrolled 175 patients with OSCC undergoing adjuvant CRT between 2011 and 2018, who were divided into groups with (n = 112) and without (n = 63) sarcopenia. Logistic regression analysis and Cox proportional hazards models were used to determine prognostic factors for CRT-related toxicity, three-year overall survival (OS), and disease-free survival (DFS). Sarcopenia and high PLR were independently associated with CRT-induced anemia (CIA); advanced tumor stage was related to poor three-year OS. CRT and survival did not differ by mFI-5 and NLR. Our results indicate that sarcopenia and high PLR are significant predictors of adjuvant CRT, increasing toxicity outcomes and indicating worse short-term OS. Accurately identifying sarcopenia and high PLR in patients with OSCC is critical to help better select candidates for adjuvant CRT to improve their outcomes.

Background: Oral squamous cell carcinoma (OSCC) is a substantial cancer burden in Taiwan, and multimodality treatment is associated with heterogeneous toxicities. Longitudinal inflammatory, immune-metabolic, and vascular biomarker changes across treatment intensities, and their links with complications, remain insufficiently defined. Purpose: To characterize biomarker trajectories across OSCC treatment modalities and identify baseline biomarkers associated with treatment-related complications. Methods: This prospective cohort study included patients with OSCC receiving surgery alone, surgery followed by concurrent chemoradiotherapy (CCRT), or CCRT followed by tegafur–uracil (UFUR) maintenance. Peripheral blood indices and vascular measures, including arterial stiffness index (ASI) and brachial–ankle pulse wave velocity (baPWV), were assessed at baseline and weeks 2, 12, and 24 after surgery. Temporal changes were analyzed using generalized estimating equations, and baseline biomarker associations with complications were examined using multivariable logistic regression. Results: Among 140 patients, 60 received surgery alone, 40 received CCRT, and 40 received CCRT followed by UFUR maintenance. Patients receiving CCRT showed sustained inflammatory activation, with neutrophil-to-lymphocyte ratio (NLR) peaking at week 12 (β = 4.90, p < 0.001). ASI and baPWV also increased in the CCRT groups at week 12. Elevated baseline NLR (≥ 3.5) was independently associated with postoperative infection (odds ratio [OR] = 1.52, p = 0.026), whereas low prognostic nutritional index (PNI < 40.5) was associated with major complications (OR = 2.85, p = 0.028). Among patients receiving CCRT, low hemoglobin (< 11 g/dL) was associated with febrile neutropenia (OR = 7.10, p = 0.003), while elevated systemic immune-inflammation index (SII ≥ 1100) and uric acid (≥ 5.3 mg/dL) were associated with severe mucositis. Conclusion: Blood-based and vascular biomarkers showed treatment-specific trajectories and were associated with clinically relevant complications. These exploratory findings may support risk-adapted toxicity monitoring in OSCC, although the proposed cutoffs require external validation.