Postoperative infection predicts poor survival in locoregionally advanced oral cancer

Head Neck. 2019 Oct;41(10):3624-3630. doi: 10.1002/hed.25885. Epub 2019 Aug 5.


Background: We ascertain the association of postoperative infection on survival in patients with locoregionally advanced oral cavity squamous cell carcinoma (OCSCC).

Methods: A retrospective study of patients with stage III/IVA OCSCC undergoing curative-intent surgery was performed. Postoperative infection was considered within 30 days after surgery. Kaplan-Meier survival curves were used to compare overall survival (OS) in patients with postoperative infection. Cox regression and propensity-score matching were used to adjust for confounders.

Results: Fifty-four of 114 patients had a postoperative infection. The 5-year OS in patients with a postoperative infection (24.1%) was lower than those without (65.2%; P < .0001). Postoperative infection was a negative predictor of OS after adjusting for patient, antibiotic, pathologic, and operative factors; the adjusted hazard ratio for OS was 2.54 (95% confidence interval, 1.27-5.09).

Conclusion: Postoperative infection is a strong negative predictor of OS in patients with OCSCC undergoing ablative surgery.

Keywords: disease-free survival; infection; oral cavity squamous cell carcinoma; overall survival; pathogen.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Cause of Death*
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Mouth Neoplasms / mortality
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / surgery*
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Oral Surgical Procedures / adverse effects*
  • Oral Surgical Procedures / methods
  • Postoperative Complications / mortality*
  • Postoperative Complications / physiopathology
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis