Park Seokhyun, Ryu JiWung, Kang Min-Kyung, Shin Dong Geum, Choi Seonghoon, Cho Jung Rae, Lee Namho
Division of Otorhinolaryngology, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, South Korea.
Division of Cardiology, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, South Korea.
Cancer Manag Res. 2025 Aug 21;17:1741-1751. doi: 10.2147/CMAR.S534580. eCollection 2025.
Prolonged major surgery for head and neck cancers presents challenges with potential implications for blood pressure fluctuations (BPF). This study aims to assess the incidence of significant BPF in such patients and explore its clinical associations.
Ninety-eight patients underwent continuous BP monitoring during and after surgery. Demographic, clinical, echocardiographic, and laboratory data, including N-terminal pro-B-type natriuretic peptide (nt-pro BNP) levels, were analyzed. Multivariate analysis identified predictors of BPF.
Thirty-five percent (n=34) exhibited significant BPF (standard deviation ≥20) post-surgery. The BPF group showed associations with recurrent cancer, lower BMI, increased complications, and higher 30-day mortality. Elevated postoperative systolic BP, wider variability, and prolonged ICU and hospital stays were observed. While echocardiographic parameters showed no significant differences, increased postoperative nt-pro BNP levels suggested a potential link to heart failure in BPF cases.
Extreme BPF in head and neck cancer surgery, particularly in recurrent cases, has significant clinical implications. The challenges in pharmacological management and patient care underscore the need for targeted interventions and vigilant monitoring. Given the elevated risk in this patient subset, implementing structured postoperative surveillance and tailored therapeutic strategies is essential to optimize outcomes and improve overall clinical care.
头颈部癌症的长时间大型手术带来了挑战，对血压波动（BPF）可能产生影响。本研究旨在评估此类患者中显著BPF的发生率，并探讨其临床关联。
98例患者在手术期间及术后接受连续血压监测。分析了人口统计学、临床、超声心动图和实验室数据，包括N末端B型利钠肽原（nt-pro BNP）水平。多变量分析确定了BPF的预测因素。
35%（n = 34）的患者术后出现显著BPF（标准差≥20）。BPF组与癌症复发、较低的体重指数、并发症增加和30天死亡率较高有关。观察到术后收缩压升高、变异性增大以及重症监护病房（ICU）和住院时间延长。虽然超声心动图参数无显著差异，但术后nt-pro BNP水平升高表明BPF病例可能与心力衰竭有关。
头颈部癌症手术中的极端BPF，尤其是在复发病例中，具有重要的临床意义。药物管理和患者护理方面的挑战凸显了针对性干预和密切监测的必要性。鉴于该患者亚组风险升高，实施结构化的术后监测和量身定制的治疗策略对于优化治疗效果和改善整体临床护理至关重要。
