{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:32:08Z","timestamp":1790191928356,"version":"4.1.0"},"reference-count":14,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"ABSTRACT<\/jats:title>\n \n Introduction<\/jats:title>\n \n Sarcopenia and frailty status have been shown to be associated with cancer patients' survival. Low alanine aminotransferase (\n ALT<\/jats:styled-content>\n ) blood activity was previously shown to be associated with frailty and poor clinical outcomes in cancer patients. This association was not addressed in head and neck cancer patients.\n <\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n \n This was a retrospective study, investigating the possible association between pre\u2010operative low\n ALT<\/jats:styled-content>\n blood levels and clinical outcomes in patients undergoing total laryngectomy due to malignancy.\n <\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n We did a retrospective analysis using the largest national Israeli HMO (Clalit health maintenance organization) database, including the demographic, clinical background, laboratory and clinical outcomes of head and neck cancer patients who underwent total laryngectomy.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 427 patients were included. Patients were divided into two groups according to their\n ALT<\/jats:styled-content>\n values: low\n ALT<\/jats:styled-content>\n (0\u201310\n IU<\/jats:styled-content>\n \/L,\n N<\/jats:italic>\n \u2009=\u2009100) and normal\n ALT<\/jats:styled-content>\n (11\u201340\n IU<\/jats:styled-content>\n \/L,\n N<\/jats:italic>\n \u2009=\u2009327). Low\n ALT<\/jats:styled-content>\n levels were associated with significantly longer duration of in\u2010hospital stay (26\u2009\u00b1\u200917 vs. 23\u2009\u00b1\u200916\u2009days, respectively;\n p<\/jats:italic>\n \u2009<\u20090.001), higher probability of 1\u2010month, post\u2010discharge unplanned visits to the emergency department (\n RR<\/jats:styled-content>\n \u2009=\u20091.66;\n p<\/jats:italic>\n \u2009<\u20090.05) and worse 1\u2010year survival rate (67% vs. 77%, respectively;\n p<\/jats:italic>\n \u2009<\u20090.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Low, pre\u2010operative\n ALT<\/jats:styled-content>\n levels are associated with worse prognosis for total laryngectomy patients.\n ALT<\/jats:styled-content>\n levels may be used for better, personalised medicine by surgeons.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/coa.70047","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T07:57:27Z","timestamp":1764662247000},"page":"307-312","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Low Alanine Aminotransferase Blood Activity, a Biomarker of Sarcopenia and Frailty, is Associated With Worse Post\u2010Total Laryngectomy Clinical Outcomes. A Retrospective Analysis of 427 Patients"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5205-2463","authenticated-orcid":false,"given":"Yarden Tenenbaum","family":"Weiss","sequence":"first","affiliation":[{"name":"Department of Otolaryngology and Neck Surgery Samson Assuta University Hospital, Ashdod, Israel. Affiliated to the Faculty of Medicine, Ben\u2010Gurion University Beer Sheba Israel"},{"name":"Ben Gurion University of the Negev Beer Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keren","family":"Oren","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Neck Surgery Samson Assuta University Hospital, Ashdod, Israel. Affiliated to the Faculty of Medicine, Ben\u2010Gurion University Beer Sheba Israel"},{"name":"Ben Gurion University of the Negev Beer Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nofar Ben Mordechai","family":"Sharon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Neck Surgery Samson Assuta University Hospital, Ashdod, Israel. Affiliated to the Faculty of Medicine, Ben\u2010Gurion University Beer Sheba Israel"},{"name":"Ben Gurion University of the Negev Beer Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomer","family":"Kerman","sequence":"additional","affiliation":[{"name":"Ben Gurion University of the Negev Beer Sheva Israel"},{"name":"Clinical Research Center Soroka University Medical Center and Faculty of Health Sciences, Ben\u2010Gurion University of the Negev Beer\u2010Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itai","family":"Hazan","sequence":"additional","affiliation":[{"name":"Ben Gurion University of the Negev Beer Sheva Israel"},{"name":"Clinical Research Center Soroka University Medical Center and Faculty of Health Sciences, Ben\u2010Gurion University of the Negev Beer\u2010Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tal","family":"Marom","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Neck Surgery Samson Assuta University Hospital, Ashdod, Israel. Affiliated to the Faculty of Medicine, Ben\u2010Gurion University Beer Sheba Israel"},{"name":"Ben Gurion University of the Negev Beer Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3286-9248","authenticated-orcid":false,"given":"Oren","family":"Ziv","sequence":"additional","affiliation":[{"name":"Clinical Research Center Soroka University Medical Center and Faculty of Health Sciences, Ben\u2010Gurion University of the Negev Beer\u2010Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gad","family":"Segal","sequence":"additional","affiliation":[{"name":"Education Authority, Chaim Sheba Medical Center, Ramat\u2010Gan, Israel. Affiliated to the Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oded","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Neck Surgery Samson Assuta University Hospital, Ashdod, Israel. Affiliated to the Faculty of Medicine, Ben\u2010Gurion University Beer Sheba Israel"},{"name":"Ben Gurion University of the Negev Beer Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.18181"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27012"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15143538"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.21873\/cdp.10222"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27903"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9103185"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2021.10.001"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890\u2010020\u20101169\u2010z"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15184606"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16010174"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/cas.14784"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11864-022-00942-8"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drup.2018.09.001"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2020.12.015"}],"container-title":["Clinical Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.70047","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/coa.70047","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.70047","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T06:37:05Z","timestamp":1771051025000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/coa.70047"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,1]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1111\/coa.70047"],"URL":"https:\/\/doi.org\/10.1111\/coa.70047","archive":["Portico"],"relation":{},"ISSN":["1749-4478","1749-4486"],"issn-type":[{"value":"1749-4478","type":"print"},{"value":"1749-4486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,1]]},"assertion":[{"value":"2025-06-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}