Unveiling Survival Predictors in Postoperative Head and Neck Cancer: A Comprehensive Analysis
Wenjie Cai, Iat-Weng Hong, Chengfeng Cai, Wanhua Chen
Background and Purpose: Head and neck malignancies remain a major global health burden, with
poor survival outcomes despite advances in treatment. This study aims to identify key factors influencing
progression-free survival (PFS) and overall survival (OS) in head and neck cancer patients, and to
assess the impact of tumor characteristics, surgical margins, and postoperative therapies.
Materials and Methods: A retrospective analysis was conducted on 306 patients with head and neck
tumors treated between 2017 and 2022. Demographic data, tumor classification, surgical margins, and
postoperative treatments were collected. Survival data were analyzed using univariate and multivariate
methods to identify factors influencing PFS and OS.
Results: Key determinants of survival identified include T and N categories,initial frozen section
margins, postoperative recurrence, and adjuvant chemotherapy and radiotherapy. Patients with
advanced T and N stages or initial positive frozen section margins exhibited significantly lower PFS
and OS. Multivariate analysis further established postoperative chemotherapy as an independent factor
negatively associated with PFS, potentially reflecting its application in advanced cases with poorer
prognosis. Subgroup analysis revealed significant survival differences across tumor types, particularly
between oral and salivary gland cancers.
Conclusion: These findings underscore the need for individualized treatment strategies and more
precise intraoperative assessments to improve outcomes. Future prospective studies are necessary to
corroborate these findings and support evidence-based clinical decision-making.
