Gimenes Paulo Victor Sola, Rocha Daniel Abreu, Kulcsar Marco Aurélio Vamondes, Cernea Claudio Roberto, Matos Leandro Luongo
Universidade de São Paulo (USP), Faculdade de Medicina (FM), Hospital das Clínicas (HC), São Paulo, SP, Brazil.
Universidade de São Paulo (USP), Faculdade de Medicina (FM), Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, Brazil.
Braz J Otorhinolaryngol. 2025 Jul;91 Suppl 1(Suppl 1):101610. doi: 10.1016/j.bjorl.2025.101610. Epub 2025 May 14.
Patients who require surgery to treat head and neck cancer are at higher risk of perioperative complications and this scenario is not different for patients with malignant tumors of the oral cavity. Thus, the objective of the present study was to identify preoperative prognostic factors related to postoperative complications in the surgical treatment of oral cancer.
Prospective study with 43 consecutive squamous cell carcinomas of the oral cavity submitted to surgical treatment with curative intent.
Seventeen patients presented postoperative complications until the thirtieth day of follow-up, of which 17.6% required surgical reoperation. The most common complications were suture dehiscence and surgical site infections. Alcohol abuse (p = 0.004), pT4a tumors (p = 0.044), tumors with thickness greater than 10 mm (p = 0.002), patients with mGPS score 1 and 2 (p = 0.027) and flap reconstruction (p < 0.001) were associated with higher rates of postoperative complications. To the multivariate analysis, patients with tumor thickness greater than 10 mm (HR = 11,240; 95% CI 1,052-120,059; p = 0.045 ‒ logistic regression) and reconstructed with myocutaneous flap (HR = 18,415; 95% CI 1,849-183,359; p = 0.013 ‒ logistic regression) had a higher risk of developing postoperative complications.
Tumor thickness greater than 10 mm or use of myocutaneous flaps in the reconstruction were the predictors of risk of postoperative complications in patients with squamous cell carcinoma of the oral cavity.
Level III.
需要手术治疗头颈癌的患者围手术期并发症风险较高，口腔恶性肿瘤患者也是如此。因此，本研究的目的是确定口腔癌手术治疗中与术后并发症相关的术前预后因素。
对43例连续的口腔鳞状细胞癌患者进行前瞻性研究，这些患者接受了根治性手术治疗。
17例患者在随访的第30天出现术后并发症，其中17.6%需要再次手术。最常见的并发症是缝线裂开和手术部位感染。酗酒（p = 0.004）、pT4a肿瘤（p = 0.044）、厚度大于10 mm的肿瘤（p = 0.002）、mGPS评分为1和2的患者（p = 0.027）以及皮瓣重建（p < 0.001）与较高的术后并发症发生率相关。多因素分析显示，肿瘤厚度大于10 mm的患者（HR = 11,240；95% CI 1,052 - 120,059；p = 0.045 - 逻辑回归）和采用肌皮瓣重建的患者（HR = 18,415；95% CI 1,849 - 183,359；p = 0.013 - 逻辑回归）发生术后并发症的风险更高。
肿瘤厚度大于10 mm或重建时使用肌皮瓣是口腔鳞状细胞癌患者术后并发症风险的预测因素。
三级。
