Surgical morbidity and mortality in patients after microvascular reconstruction for head and neck cancer

Surgical morbidity and mortality in patients after microvascular reconstruction for head and neck... KeypointsThe perioperative comorbidity score was associated with surgical mortality.Pharyngocutaneous fistula and flap compromise were more frequent as perioperative comorbidity score increased.Perioperative comorbidity score was significantly correlated with 5‐year disease‐specific survival by multivariate analysis.INTRODUCTIONThe importance of surgical excision of head and neck squamous cell carcinoma (HNSCC) with respect to disease control, survival duration and quality of life is well established. Accordingly, surgery remains the primary therapeutic intervention for most patients with HNSCC. Recent advances in anaesthetic and surgical techniques, including microvascular reconstruction, have allowed the use of more radical oncologic procedures for advanced head and neck cancer. However, the curative intent of surgery can be limited by the hazard of life‐threatening perioperative complications.Accurate prediction of surgical morbidity and mortality is important not only for appropriate selection of candidates for surgery, but also for evaluation of quality of care and policy decisions. The most common risk factors that predispose patients to the development of HNSCC will collaterally and concurrently select for a population of patients of advanced age, often with significant chronic comorbidities such as cardiovascular and pulmonary disease along with tobacco and alcohol abuse as well as below‐average nutritional status as risk factors. All of these factors lead to an http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Clinical Otolaryngology Wiley

Surgical morbidity and mortality in patients after microvascular reconstruction for head and neck cancer

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 John Wiley & Sons Ltd
ISSN
1749-4478
eISSN
1749-4486
D.O.I.
10.1111/coa.13006
Publisher site
See Article on Publisher Site

Abstract

KeypointsThe perioperative comorbidity score was associated with surgical mortality.Pharyngocutaneous fistula and flap compromise were more frequent as perioperative comorbidity score increased.Perioperative comorbidity score was significantly correlated with 5‐year disease‐specific survival by multivariate analysis.INTRODUCTIONThe importance of surgical excision of head and neck squamous cell carcinoma (HNSCC) with respect to disease control, survival duration and quality of life is well established. Accordingly, surgery remains the primary therapeutic intervention for most patients with HNSCC. Recent advances in anaesthetic and surgical techniques, including microvascular reconstruction, have allowed the use of more radical oncologic procedures for advanced head and neck cancer. However, the curative intent of surgery can be limited by the hazard of life‐threatening perioperative complications.Accurate prediction of surgical morbidity and mortality is important not only for appropriate selection of candidates for surgery, but also for evaluation of quality of care and policy decisions. The most common risk factors that predispose patients to the development of HNSCC will collaterally and concurrently select for a population of patients of advanced age, often with significant chronic comorbidities such as cardiovascular and pulmonary disease along with tobacco and alcohol abuse as well as below‐average nutritional status as risk factors. All of these factors lead to an

Journal

Clinical OtolaryngologyWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

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