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Complications After Transoral Surgery for Oropharyngeal Cancer: An ACS-NSQIP Database Study
Stephanie Wong1, Liyang Tang1, Daniel Kwon1
1Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of USC, Los Angeles, California, U.S.A.
The Laryngoscope
|January 21, 2025
Summary
Transoral surgery (TOS) for oropharyngeal squamous cell carcinoma (OPSCC) is safe, with low complication rates. Smoking, diabetes, congestive heart failure (CHF), and American Society of Anesthesiologists (ASA) class 3+ are key risk factors for adverse outcomes.
Area of Science:
- Oncology
- Surgical Oncology
- Otolaryngology
Background:
- Transoral surgery (TOS) for oropharyngeal squamous cell carcinoma (OPSCC) carries risks, including perioperative mortality from bleeding.
- While 30-day mortality and morbidity are generally low, identifying specific risk factors for complications is crucial for patient safety.
Purpose of the Study:
- To identify preoperative risk factors associated with complications following TOS for OPSCC.
- To analyze data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database.
Main Methods:
- Retrospective cohort analysis of 3,489 patients undergoing TOS for OPSCC (2010-2021).
- Collected preoperative risk factors and analyzed 30-day readmission, reoperation, hemorrhage, and death rates.
- Utilized univariate and multivariate analyses to determine risk factor associations.
Main Results:
- The study included 3,489 patients (mean age 60.6 years, 81.5% male).
- 30-day mortality was 0.7% (24 deaths), with readmission and reoperation rates of 8.9% and 5.8%, respectively.
- Smoking, diabetes, congestive heart failure (CHF), and American Society of Anesthesiologists (ASA) 3+ were significantly associated with increased risks of readmission, reoperation, and hemorrhage.
Conclusions:
- Transoral surgery (TOS) for oropharyngeal squamous cell carcinoma (OPSCC) demonstrates a favorable safety profile with low 30-day complication rates.
- Preoperative identification of risk factors such as smoking, diabetes, CHF, and ASA 3+ is essential for mitigating potential complications.
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