术后感染预示着局部晚期口腔癌患者的生存状况不佳。
Postoperative infection predicts poor survival in locoregionally advanced oral cancer.
机构信息
Department of Otolaryngology-Head and Neck Surgery, McGill University Health Centre, Quebec, Canada.
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Quebec, Canada.
出版信息
Head Neck. 2019 Oct;41(10):3624-3630. doi: 10.1002/hed.25885. Epub 2019 Aug 5.
BACKGROUND
We ascertain the association of postoperative infection on survival in patients with locoregionally advanced oral cavity squamous cell carcinoma (OCSCC).
METHODS
A retrospective study of patients with stage III/IVA OCSCC undergoing curative-intent surgery was performed. Postoperative infection was considered within 30 days after surgery. Kaplan-Meier survival curves were used to compare overall survival (OS) in patients with postoperative infection. Cox regression and propensity-score matching were used to adjust for confounders.
RESULTS
Fifty-four of 114 patients had a postoperative infection. The 5-year OS in patients with a postoperative infection (24.1%) was lower than those without (65.2%; P < .0001). Postoperative infection was a negative predictor of OS after adjusting for patient, antibiotic, pathologic, and operative factors; the adjusted hazard ratio for OS was 2.54 (95% confidence interval, 1.27-5.09).
CONCLUSION
Postoperative infection is a strong negative predictor of OS in patients with OCSCC undergoing ablative surgery.
背景
本研究旨在确定术后感染与局部晚期口腔鳞状细胞癌（OCSCC）患者生存之间的关系。
方法
本研究回顾性分析了接受根治性手术的 III/IVA 期 OCSCC 患者。术后感染定义为术后 30 天内发生的感染。Kaplan-Meier 生存曲线用于比较术后感染患者的总生存率（OS）。采用 Cox 回归和倾向评分匹配来调整混杂因素。
结果
114 例患者中有 54 例发生术后感染。术后感染患者的 5 年 OS（24.1%）低于无术后感染患者（65.2%；P<0.0001）。在调整了患者、抗生素、病理和手术因素后，术后感染仍然是 OS 的负预测因素；调整后的 OS 风险比为 2.54（95%置信区间，1.27-5.09）。
结论
对于接受根治性手术的 OCSCC 患者，术后感染是 OS 的强烈负预测因素。
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