Prognostic significance of postoperative wound infections after total laryngectomy.

Abstract

In oncologic surgery, the relationship between postoperative wound infections and prognosis remains unclear. The purpose of this study was to establish the prognostic significance of surgical wound infections in laryngectomized patients. We studied 129 consecutive patients with previously untreated laryngeal or hypopharyngeal squamous cell carcinoma who underwent a total laryngectomy. Minimum follow-up was 24 months. Fifty-seven patients (44%) developed a wound infection. Infections were more frequent in hypopharyngeal tumors (p < .001). Surgical wound infection was associated with a worse disease-specific survival (p = .046), but this association was due to the hypopharyngeal subgroup of cases (p = .024). In multivariate analysis, the only parameters significantly associated with a worse disease-specific survival in these cases were nodal extracapsular invasion (p < .001) and surgical wound infection (p = .02). Our results suggest that the development of a postoperative wound infection is a poor prognostic sign in patients with advanced hypopharyngeal cancers surgically treated.