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Relationship between postoperative complications and survival after free flap reconstruction for oral cavity squamous cell carcinoma
Author(s) -
Ch'ng Sydney,
Choi Vincent,
Elliott Michael,
Clark Jonathan R.
Publication year - 2014
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23266
Subject(s) - medicine , proportional hazards model , hazard ratio , surgery , confidence interval , complication , survival analysis , head and neck cancer , basal cell , head and neck squamous cell carcinoma , log rank test , free flap reconstruction , carcinoma , head and neck , radiation therapy
Background 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. Methods 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). Results 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. Conclusions Major postoperative complications are independently associated with decreased OS. © 2013 Wiley Periodicals, Inc. Head Neck 36 : 55–59, 2014