Impact of malnutrition defined by Global Leadership Initiative on Malnutrition criteria on prognosis in oral squamous cell carcinoma.

Abstract

Patients with oral squamous cell carcinoma (OSCC) may present with malnutrition prior to treatment due to oral dysfunction such as pain and dysphagia. However, limited data are available regarding the preoperative malnutrition and its prognostic impact in OSCC patients when assessed using the Global Leadership Initiative on Malnutrition (GLIM) criteria. The purpose of this study was to investigate the association between preoperative malnutrition assessed by the GLIM criteria and overall survival and disease-free survival in patients with OSCC. This retrospective study included 187 patients with OSCC who underwent primary surgical treatment. Preoperative nutritional status was evaluated using the GLIM criteria and classified as non-malnutrition, moderate malnutrition, or severe malnutrition. Overall survival and disease-free survival were analyzed using Cox proportional hazards models. Among the 187 patients included in this study, malnutrition according to the GLIM criteria was diagnosed in 18.2% of the patients, including 11.2% with moderate malnutrition and 7.0% with severe malnutrition. In multivariable Cox proportional hazards analysis, severe malnutrition defined by the GLIM criteria was identified as an independent unfavorable prognostic factor for both overall survival (hazard ratio (HR) 3.09, 95% confidence interval (CI) 1.52-6.31, P < 0.01) and disease-free survival (HR 2.27, 95% CI 1.19-4.32, P = 0.02). Preoperative malnutrition assessed by the GLIM criteria, particularly severe malnutrition, was shown to have a significant impact on prognosis in patients with OSCC. Further studies are required to evaluate nutritional interventions and supportive care aimed at improving survival outcomes in malnourished OSCC patients.