University of Adelaide, Adelaide, SA, Australia.
Royal Australasian College of Surgeons.
Int J Oral Maxillofac Surg. 2021 Jan;50(1):1-6. doi: 10.1016/j.ijom.2020.07.011. Epub 2020 Aug 7.
Survival rates for oral squamous cell carcinoma (OSCC) has remained stagnant in recent years and improving surgical mortality could be an avenue to enhance outcomes. This systematic review aims to identify the causes of mortalities, determine both the modifiable and non-modifiable factors involved and target a reduction in postoperative 30-day mortality. In May 2019, a comprehensive search of key databases including PubMed, EMBASE, Cochrane Library was conducted. Blinded selection by two researchers identified papers that included participants who received oral squamous cell carcinoma resection and suffered an in-hospital or 30-day mortality. Selection identified two relevant papers that meet the inclusion criteria. One study had one death in its population sample but only had the cause of death described. Another study had an overall surgical mortality rate of 1% in a population of 21,681. Patients with multiple factors had the highest mortality rates; 4.6% in patients >85 years old and have a T4 diagnosis, 3.9% in patients with a Comorbidity Index ≥1 and a T4 diagnosis. These studies did not determine relationships between factors and causes of death. There are significant knowledge gaps in the literature, that can be addressed through further population analysis studies.
近年来，口腔鳞状细胞癌（OSCC）的生存率一直停滞不前，降低手术死亡率可能是提高治疗效果的途径。本系统综述旨在确定死亡率的原因，确定涉及的可改变和不可改变因素，并降低术后 30 天死亡率。2019 年 5 月，对包括 PubMed、EMBASE、Cochrane Library 在内的主要数据库进行了全面检索。由两名研究人员进行的盲选确定了纳入了接受口腔鳞状细胞癌切除术并发生院内或 30 天内死亡的参与者的论文。选择确定了两份符合纳入标准的相关论文。一项研究在其人群样本中仅有一例死亡，但仅描述了死亡原因。另一项研究在 21681 例患者中总体手术死亡率为 1%。具有多种因素的患者死亡率最高；85 岁以上且 T4 诊断的患者为 4.6%，合并症指数≥1 且 T4 诊断的患者为 3.9%。这些研究没有确定因素与死亡原因之间的关系。文献中存在显著的知识空白，可以通过进一步的人群分析研究来解决。
