Perioperative Complications, Comorbidities, and Survival in Oral or Oropharyngeal Cancer

Abstract

Clinical variables have a predictive effect on morbidity and mortality of patients with oral and oropharyngeal cancer treated surgically. Local plus systemic perioperative complications can adversely affect the prognosis. The uniformity of results confirms that survival estimates can be enhanced by the addition of clinical characteristics to the TNM classification, creating a more accurate system for the estimation of prognosis.

Oral squamous cell carcinoma: Review of prognostic and predictive factors

“…10 The correlation of prognosis with age seems controversial, and some authors show no relationship between them, 7-9,11 whereas others demonstrate worse prognosis in older patients. 10,12 Tobacco and alcohol. Although some results deny any association between survival and smoked tobacco or alcohol consumption, 7 most authors report higher mortality in smokers and alcohol drinkers.…”

“…Although some results deny any association between survival and smoked tobacco or alcohol consumption, 7 most authors report higher mortality in smokers and alcohol drinkers. 10,12,13 Betel quid chewing (a common habit in some regions of Asia and some Asian communities in the western world) has been specifically correlated with poorer prognosis. 7 Smokers and alcohol drinkers seem to be at higher risk for the development of second primary oral cancer than nonsmokers and nondrinkers, thus facing more onerous outcomes.…”

“…Comorbid conditions may worsen disease outcome as a consequence of increased organic stress afflicting the patient. 12,13,20 Survival rates are lower in patients with concomitant OSCC and disorders such as congestive heart failure, arrhythmias, peripheral vascular disease, pulmonary and renal diseases, and other cancers, either treated or untreated. 20 Depressed host immune status seems to play an adverse role on survival of patients with oral cancer.…”

“…22,23 Some specific symptoms, such as odynophagia, oral abnormal hemorrhage, and weight loss, also have been correlated with shorter survival. 12 Weight loss is associated with higher mortality rates in patients with OSCC with recurrence or persistence of disease, or second primary tumor. 9 Tumor-related factors Anatomic site.…”

“…Cancer staging is based on the TNM system, which has been labeled as imperfect, per se, for prognostic purposes. 8,9,12,13,[26][27][28][29][30] However, the vast majority of authors accepts that disease staging has a crucial influence on the outcome. Guerra et al 31 reported 5-year survival rates of 82% for initial stages and 49% for advanced disease.…”