ArticleThe Laryngoscope2025
Surgical Complications for Oral Cavity Cancer: Evaluating Hospital Performance.
Article in The Laryngoscope, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Textbook Outcome After Oral Cancer Surgery as a Composite Measure for Survival and Quality-of-Care Evaluation.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2025Article
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Authors and funding
22 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveComplications of oral cavity cancer (OCC) surgery have an impact on the quality of life. Therefore, evaluating hospital performance on complication rates can help identify best practices for improving the quality of OCC care. As patient and tumor characteristics also impact hospital results, case-mix adjustment should be considered to provide a valid hospital comparison. This study investigated hospital variation in the quality indicator "a complicated postoperative course" after OCC surgery.
methodsThis population-based cohort included all first primary OCC patients diagnosed between 2018 and 2021 who were surgically treated with curative intent. A complicated postoperative course was defined as 30-day mortality, unplanned readmission, surgical complications requiring reintervention or prolonged hospital stay, or fistula formation. Hospital performance was analyzed using funnel plots with case-mix correction.
resultsA total of 2,266 OCC patients could be included. The distribution of case-mix variables varied significantly between hospital populations. Nationally, a complicated postoperative course occurred in 13.9% and uncorrected hospital rates ranged from 2.7% to 31.1%. A WHO performance score ≥2, cT3-T4 tumors, and floor-of-mouth tumors were associated with an increased risk of a complicated postoperative course, and non-squamous cell carcinoma with a decreased risk. Significant outliers remained after case-mix correction for patient, tumor, and treatment characteristics.
conclusionComplications after OCC surgery are prevalent, especially regarding extensive tumors and surgery. To identify best practices in OCC surgery, hospital performance on a complicated postoperative course should be adjusted for case-mix and treatment variables. Providing feedback on hospital performance for complications can instigate improvement plans for better outcomes. LEVEL OF EVIDENCE: 3 Laryngoscope, 135:2411-2419, 2025.
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