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Αλέξανδρος Γ. Σφακιανάκης

Friday, May 21, 2021

Factors predictive of 90‐day mortality after surgical resection for oral cavity cancer: Development of a recursive partitioning analysis for risk stratification

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Abstract

Background

Factors that influence postoperative mortality (POM) have been identified, but a predictive model to guide clinicians treating oral cavity cancer (OCC) has not been well established.

Methods

Patients with OCC undergoing upfront surgical resection were included. Primary outcome was 90-day POM (90dPOM).

Results

33 845 were identified using the National Cancer Database. Rate of 90dPOM was 3.2%. Predictors of higher 90dPOM include older age, higher comorbidity scores, nonprivate insurance, lower income, treatment in an academic facility, higher T- and N-classification, radical excision, and presence of positive margins. On RPA, two high-risk (90dPOM > 10%) patient subsets were identified: patients ≥80 years of age with T3-4 disease and patients <80 years, with any comorbidity and T3-4, N2-3 disease.

Conclusions

We identified a subset of patients in this cohort who are at high risk for 90dPOM. These patients may warrant additional perioperative and postoperative monitoring in addition to better preoperative assessment and screening.

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