Postoperative wound infection. A poor prognostic sign for patients with head and neck cancer.
BACKGROUND
The development of a wound infection has been identified as a favorable prognostic factor after oncologic surgical procedures.


METHODS
The authors retrospectively studied the relationship between postoperative wound infection, local/regional tumor recurrence, and survival rates in 134 patients undergoing therapeutic surgical resection for squamous cell carcinoma of the head and neck (SCCHN).


RESULTS
The median age was 61 years (range, 25-87 years) with most (75%) patients having advanced disease (Stage III or IV). Patients without evidence of recurrent disease were followed up for a median time of 34 months (range, 24-68 months). Twenty-nine (22%) had local or regional bacterial infections develop postoperatively. Recurrence rates were increased (P = 0.008) in patients with postoperative wound infections compared with patients who had distant infections, e.g., pneumonia or urinary tract infection, or no infection. Disease-free survival also was adversely affected (P = 0.04) in this group. Both advanced tumor stage and postoperative wound infections were independently associated with decreased survival, with odds ratios of 2:3 and 2:4, respectively.


CONCLUSIONS
These data contrast with other reports in the literature of a beneficial effect of postoperative wound infection on outcome. These findings suggest a possible relationship between local/regional immune function and postoperative infection in patients with SCCHN:
Grandis
J R
JR
Department of Otolaryngology, University of Pittsburgh School of Medicine, Pennsylvania.
Snyderman
C H
CH
Johnson
J T
JT
Yu
V L
VL
D'Amico
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000276:immunology / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000276:immunology / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000276:immunology / Q000401:mortality; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000276:immunology / Q000382:microbiology / Q000401:mortality*