Clinical factors associated with severe surgical complications in patients with hypopharyngeal cancer: a single-center case-cohort study

Abstract

Background Surgical complications are a major concern in the surgical treatment of hypopharyngeal cancer. Objective To identify clinical factors that predispose patients with hypopharyngeal cancer to severe surgical complications. Materials and methods The data of 449 patients who were underwent surgery as a part of the initial treatment with curative intent or as salvage treatment were retrospectively reviewed. The Chi-square test and logistic regression were used to evaluate the association of different factors with severe surgical complications. Results The incidence of severe complications was 22% (99/449), and 10 patients (2.2%) experienced rupture of the carotid artery. Multivariate analysis identified T3/4 stage (p = .002, odds ratio (OR) = 1.58, 95% confidence interval (CI) 1.177–2.122), radiotherapy (RT) (p < .001, OR = 2.744, 95% CI 1.680–4.482), diabetes mellitus (DM) (p = .007, OR = 2.697, 95% CI 1.308–5.56), and nonprimary closure (p = .008, OR = 1.992, 95% CI 1.193–3.327) as significant risk factors for severe surgical complications. Conclusions and significance T3/4 stage, RT, nonprimary closure, and DM were independent predisposing factors for severe surgical complications in our study population of hypopharyngeal cancer patients. Taking measures to lower the tumor stage and simplify the surgical procedure may be crucial in reducing the incidence of severe surgical complications among these patients.