Prognostic Impact of Postoperative Complications on Overall Survival in 287 Patients With Oral Cancer: A Retrospective Single-Institution Study

Abstract

Purpose: To investigate the relation between postoperative complications and long-term survival in patients with oral cancer after surgery and to explore the methods that improve survival rate through analyzing risk factors for postoperative complications.

Materials and methods: This is a retrospective single-institution study of a cohort of 287 patients with oral cancer who underwent surgery at the Stomatological Hospital of the Chongqing Medical University (Chongqing, China) from January 1, 2007 through December 31, 2012.

Results: Postoperative complications occurred in 80 patients (27.9%). Patients with pulmonary complications or delirium had worse overall survival than those without these complications, whereas other postoperative complications, such as surgical site infection, postoperative bleeding, salivary fistula, and chylothorax, were not associated with overall survival. American Society of Anesthesiologists (ASA) status and tracheostomy were risk factors for postoperative pulmonary complications according to the Pearson χ² test or multivariate analysis. Using the Pearson χ² test, age, comorbidity, and ASA status were risk factors for the incidence of postoperative delirium. However, in multivariate analysis, only comorbidity and ASA status were identified as risk factors.

Conclusions: Postoperative pulmonary complications and postoperative delirium could be independent predictors of poorer long-term survival in patients with oral cancer. The risk factors for postoperative pulmonary complications and postoperative delirium could help identify patients who are at high risk and help clinicians take some actions to prevent them.