Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Head Neck. 2014 Jan;36(1):55-9. doi: 10.1002/hed.23266. Epub 2013 Apr 4.
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.
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).
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.
Major postoperative complications are independently associated with decreased OS.
目前关于头颈部癌症术后并发症对生存结果影响的文献仍然存在矛盾。本研究评估了在复杂的手术消融和口腔鳞状细胞癌重建后，术后并发症是否对生存产生不利影响。
共纳入 255 例具有完整临床病理数据的连续患者。使用对数秩检验确定生存情况，并生成 Kaplan-Meier 生存曲线。使用 Cox 比例风险模型调整其他显著协变量的影响，以确定并发症变量对总生存（OS）的独立影响。使用竞争风险模型进行疾病特异性生存（DSS）分析。
多变量分析显示，主要并发症独立预测 OS 降低[风险比（HR）2.4，95%置信区间（CI）1.1-3.2，p =.02]。任何并发症变量与 DSS 或复发均无关联。
主要术后并发症与 OS 降低独立相关。
