Arterial lactate as a predictor of postoperative complications in head and neck squamous cell carcinoma

Abstract Introduction Surgery is one of the most frequently used options in the treatment of head and neck squamous cell carcinoma. In surgical patients, the use of arterial lactate to assess hypoxemia and severe inflammatory states is well-founded. However, there are few studies on its use in patients with head and neck squamous cell carcinoma. The aim of this study was to investigate whether the serum arterial lactate level on the 1st postoperative day would be a predictor of postoperative complications in head and neck squamous cell carcinoma surgeries. Methods This is a prospective cohort, which evaluated 44 adult patients of both genders, with HNSCC, who underwent surgery associated with monobloc neck dissection as an initial treatment. Patients were divided into two groups, according to the presence or absence of postoperative complications: with complication (Clavien-Dindo II-V) and without complications (Clavien-Dindo 0-I). Student’s t-test and its variants were used to compare continuous data. Pearson’s or Spearman’s test was used to correlate the data and p values 1.7 mmoL/L was identified, with a sensitivity of 65.38% and specificity of 66.67%. Conclusion Arterial lactate measured on the first postoperative day is a good predictor of postoperative complications in patients with head and neck squamous cell carcinoma.

摘要
手术是头颈部鳞状细胞癌（Head and Neck Squamous Cell Carcinoma, HNSCC）临床治疗的常用手段之一。对于外科手术患者而言，利用动脉乳酸水平评估低氧血症与重度炎症状态的应用已有充分循证依据。然而，针对头颈部鳞状细胞癌患者开展的动脉乳酸相关研究却相对匮乏。本研究旨在探讨术后首日血清动脉乳酸水平是否可作为头颈部鳞状细胞癌术后患者并发症发生风险的预测指标。

研究方法
本研究为前瞻性队列研究，共纳入44名成年患者（性别不限），均为接受整块颈部清扫术联合手术作为初始治疗的头颈部鳞状细胞癌患者。根据术后并发症发生情况将患者分为两组：并发症组（Clavien-Dindo分级Ⅱ~Ⅴ级）与无并发症组（Clavien-Dindo分级0~Ⅰ级）。连续型数据的组间比较采用Student t检验及其衍生方法；数据相关性分析采用Pearson检验或Spearman检验。当截断值设定为1.7mmol/L时，该指标的诊断灵敏度为65.38%，特异度为66.67%。

结论
术后首日检测的动脉乳酸水平可作为头颈部鳞状细胞癌手术患者术后并发症的良好预测因子。