Neoadjuvant Immunochemotherapy Reduces Major Wound Complications in Oral Cancer Surgery

Area of Science:

• Oncology
• Surgical Oncology
• Immunotherapy

Background:

• Neoadjuvant immunochemotherapy (NICT) is an emerging treatment for locally advanced oral squamous cell carcinoma (OSCC).
• The impact of NICT on postoperative wound healing in OSCC patients is not well understood.
• This study compares wound complication rates between NICT and upfront surgery (US) in OSCC patients.

Purpose of the Study:

• To evaluate the effect of NICT on major postoperative wound complications in locally advanced OSCC.
• To compare wound healing times, hospital stay, and adjuvant therapy delays between NICT and US groups.
• To assess the perioperative safety of NICT in the context of surgical outcomes.

Main Methods:

• Retrospective cohort study including 466 patients with resectable OSCC (278 NICT, 188 US).
• 1:1 propensity score matching was used to balance covariates influencing treatment selection and wound healing, resulting in 145 matched pairs.
• Primary outcome: incidence of major wound complications (Clavien-Dindo ≥ III) within 90 days. Secondary outcomes: healing time, length of stay, adjuvant therapy delay.

Main Results:

• Matched analysis showed significantly lower major wound complication rates in the NICT group (15.2% vs. 24.8%, p=0.041).
• Upfront surgery was an independent predictor of complications (OR=2.15, p=0.016).
• NICT group experienced shorter healing times (HR=0.66, p=0.014), shorter hospital stays (10 vs. 12 days, p=0.008), and fewer adjuvant therapy delays (18.6% vs. 31.0%, p=0.015).

Conclusions:

• NICT is associated with a significantly reduced risk of major wound complications and accelerated healing compared to upfront surgery in locally advanced OSCC.
• These findings support the perioperative safety of NICT and its potential to enhance surgical outcomes.
• Prospective studies are needed for further validation.