The Effect of tumor subsite on short-term outcomes and costs of care after oral cancer surgery

Ryan Li, Carole Fakhry, Wayne M. Koch, Christine G. Gourin

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Objectives/Hypothesis To determine if epidemiologic differences exist between patients with oral tongue carcinoma compared to tumors arising from other oral cavity subsites, and the relationship between primary site and in-hospital mortality, postoperative complications, length of stay, and costs in patients undergoing surgery for oral cavity cancer. Study Design Retrospective cross-sectional study. Methods The Nationwide Inpatient Sample was analyzed for patients who underwent an ablative procedure for a malignant oral cavity neoplasm in 2001 to 2008 using cross-tabulations and multivariate regression modeling. Results Overall, there were 45,071 patients treated surgically for oral cavity cancer, with oral tongue cancer comprising 35% of all oral cavity tumors. Patients with oral tongue cancer were significantly more likely to be female (odds ratio [OR] = 1.4) and undergo neck dissection (OR = 1.4), and significantly less likely to be black (OR = 0.4), over 40 years of age (OR = 0.4), have Medicaid payer status (OR = 0.7), advanced comorbidity (OR = 0.7), receive care at a teaching hospital (OR = 0.5), and undergo pedicled or free flap reconstruction (OR = 0.6, P <.001). Oral tongue primary site was not associated with in-hospital mortality or surgical complications, but was significantly associated with a reduced incidence of medical complications (OR = 0.8, P =.005). After controlling for all other variables, oral tongue primary site disease was associated with a significantly reduced length of hospitalization and hospital-related costs. Conclusions Oral tongue cancer is associated with a distinct epidemiologic profile compared to other oral cavity cancer subsites, and is associated with lower postoperative morbidity, length of hospitalization, and hospital-related costs. Further investigation is warranted to determine if biologic factors underlie these observations. Level of Evidence 2c. Laryngoscope, 2013

Original languageEnglish (US)
Pages (from-to)1652-1659
Number of pages8
JournalLaryngoscope
Volume123
Issue number7
DOIs
StatePublished - Jul 1 2013

Keywords

  • Nationwide Inpatient Sample
  • Oral tongue neoplasm
  • complications
  • epidemiology
  • head and neck neoplasms
  • oral cavity neoplasms
  • surgery

ASJC Scopus subject areas

  • Otorhinolaryngology

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