A Retrospective Analysis of 8457 Glossectomy Cases Over 15 Years-The Boon and Bane of Radical Neck Dissection.

Abstract

Background: Glossectomy is a commonly performed procedure in head and neck oncology, primarily for the treatment of squamous cell carcinoma of the tongue. Radical neck dissection (RND) is still being combined with glossectomy to manage lymph node metastases, yet its impact on postoperative outcomes in glossectomy patients remains largely underexplored.

Methods: This study utilized data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) to analyze 30-day postoperative outcomes in 8457 patients who underwent partial or extended glossectomy, with or without concurrent RND, between 2008 and 2022.

Results: No significant differences in 30-day postoperative complications were found between partial and extended glossectomy groups (P=0.571). However, extended glossectomy with concurrent RND was associated with longer operative times (P<0.001), increased length of hospital stay (P=0.045), and higher complication rates (P=0.008). In partial glossectomy patients, concurrent RND was linked to higher 30-day mortality (P=0.022). Multivariable analysis identified smoking status, obesity, and inpatient setting as significant risk factors for postoperative complications across all subgroups.

Conclusion: While the extent of glossectomy did not influence immediate postoperative outcomes, concurrent RND significantly increased complication risks in extended glossectomy patients. These findings emphasize the importance of individualized risk assessment and tailored surgical planning to enhance patient outcomes in glossectomy procedures.