Postoperative Complications of Free Flap Reconstruction in Moderate-Advanced Head and Neck Squamous Cell Carcinoma: A Prospective Cohort Study Based on Real-World Data.
Postoperative Complications of Free Flap Reconstruction in Moderate-Advanced Head and Neck Squamous Cell Carcinoma: A Prospective Cohort Study Based on Real-World Data.
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DOI：
10.3389/fonc.2022.792462
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发表时间：
2022
影响因子：
4.7
通讯作者：
Feng, Zhien
中科院分区：
文献类型：
--
作者：
Li, Delong;Wang, Chong;Wei, Wei;Li, Bo;Liu, Huan;Cheng, Aoming;Niu, Qifang;Han, Zhengxue;Feng, Zhien
关键词：
中晚期头颈部鳞状细胞癌（HNSCC）游离皮瓣重建术后并发症（POCs）很少受到关注。我们调查了导致POCs的危险因素及其对治疗和预后的影响。在北京口腔医院进行了一项单中心、前瞻性队列研究，研究对象是2015年至2020年期间接受治疗的原发性HNSCC患者。本研究共纳入了399例连续接受原发肿瘤根治和游离皮瓣重建的HNSCC患者，其中155例（38.8%）经历了POCs。POCs的发生直接导致短期预后较差，长期总生存期较差（P=0.0056）。术前体重减轻（P=0.097）、肿瘤部位（P=0.002）、T4b分期（P=0.016）、ACE-27指数2-3 （P=0.040）、手术时间≥8h （P=0.001）、克林霉素作为抗生素预防（P=0.001）与POCs有显著相关性。POCs的发生明显导致短期预后恶化，增加患者负担。
Postoperative complications (POCs) of moderate-advanced head and neck squamous cell carcinoma (HNSCC) after free flap reconstruction have received little attention. We investigated the risk factors that lead to POCs and their impact on management and prognosis. A single-center, prospective cohort study was conducted at Beijing Stomatological Hospital on primary HNSCC patients treated between 2015 and 2020. In total, 399 consecutive HNSCC patients who underwent radical resection of the primary tumor and free flap reconstruction were enrolled in this study, 155(38.8%) experienced POCs. The occurrence of POCs directly led to worse short-term outcomes and poorer long-term overall survival (P=0.0056). Weight loss before the operation (P=0.097), Tumor site (P=0.002), stage T4b (P=0.016), an ACE-27 index of 2-3 (P=0.040), operation time≥8h (P=0.001) and Clindamycin as antibiotic prophylaxis (P=0.001) were significantly associated with POCs. The occurrence of POCs significantly leads to worse short-term outcomes and increases the patients’ burden.
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