ASA grade and disease-free mortality in head and neck cancer patients: a prospective study.
Complex surgery with curative intent as part of the care of patients with head and neck cancer, who also have serious coexisting conditions is sometimes viewed critically as being unduly, optimistic. We have used American Society of Anesthesiologists' (ASA) grading by a single anaesthetist prospectively as a baseline to investigate a possible link between coexisiting conditions and disease-free survival in 114 patients with head and neck cancer patients treated by the same anaesthetist and surgical team, and found that the ASA grade is not a reliable predictor of disease-free survival. There was no significant association between ASA grade and overall mortality, but there was a significant association between ASA grade and mortality associated with metastatic disease. However, the test for trend was not significant, which suggested that deaths from metastatic disease did not increase in line with ASA grading. All patients in ASA grades II and III were alive 2 years after their initial operation and the risk of mortality after 2 years may increase by up to 10%.
Kanatas
Anastasios
A
Oral and Maxillofacial Surgery, Oral and Facial Specialties Department, Pinderfields General Hospital, Aberford Road, Wakefield, WF1 4DG, United Kingdom. a.kanatas@doctors.org.uk
Gorton
Heather
H
Smith
Adam B
AB
Mannion
Christopher
C
Ong
Thian K
TK
Mitchell
David
D
D000776:Anesthesiology; D002423:Cause of Death; D018572:Disease-Free Survival; D004739:England / Q000453:epidemiology; D005544:Forecasting; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000601:surgery; D006305:Health Status Indicators; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D009362:Neoplasm Metastasis; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome