Relationship between postoperative complications and survival after free flap reconstruction for oral cavity squamous cell carcinoma

Head Neck. 2014 Jan;36(1):55-9. doi: 10.1002/hed.23266. Epub 2013 Apr 4.

Abstract

Background: Current literature on the effect of postoperative complications on survival outcomes in head and neck cancers remains contradictory. This study assesses whether postoperative complications adversely affect survival in cases of complex surgical ablation and reconstruction of oral squamous cell carcinoma.

Methods: In all, 255 consecutive patients with complete clinicopathologic data were included. Survival was determined using the log-rank test and Kaplan-Meier survival curves were generated. A Cox proportional hazards model was used to adjust for the effect of other significant covariates to determine the independent effect of complication variables for overall survival (OS). A competing risk model was used for disease-specific survival (DSS).

Results: On multivariable analysis, major complications independently prognosticated for reduced OS [hazard ratio (HR) 2.4, 95% confidence interval (CI) 1.1-3.2, p = .02]. There was no evidence for an association between any complication-variable and DSS or recurrence.

Conclusions: Major postoperative complications are independently associated with decreased OS.

Keywords: oral squamous cell carcinoma; postoperative complications; survival.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Cause of Death
  • Databases, Factual
  • Disease-Free Survival
  • Female
  • Free Tissue Flaps
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Mouth Neoplasms / mortality*
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / surgery*
  • Multivariate Analysis
  • Neoplasm Invasiveness / pathology
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy
  • Neoplasm Staging
  • Oral Surgical Procedures / adverse effects
  • Oral Surgical Procedures / methods
  • Plastic Surgery Procedures / adverse effects*
  • Plastic Surgery Procedures / methods
  • Postoperative Complications / mortality*
  • Postoperative Complications / physiopathology
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Survival Analysis