Non-Cochrane · prognostic · PM42180086
Incidence and influencing factors of surgical site infection in patients with oral cancer: a systematic review and meta-analysis.
Qin Xin-Ya, Yang Jie-Bin, Liu Ya-Mei, et al. · Frontiers in oncology · 2026 · PubMed · doi:10.3389/fonc.2026.1796067
Findings
Population Patients with oral cancer undergoing surgery
34 findings
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · N(+) | Incidence (pooled proportion) 0.39 [0.28, 0.50] GRADE not reported 8 studies · 663 participants |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · Buccal | Incidence (pooled proportion) 0.30 [0.23, 0.36] GRADE not reported 9 studies · 1237 participants |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · Clinical stage I-II | Incidence (pooled proportion) 0.21 [0.14, 0.27] GRADE not reported 8 studies · 1208 participants |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · Suture | Incidence (pooled proportion) 0.07 [0.05, 0.09] GRADE not reported 5 studies · 502 participants |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · Palate | Incidence (pooled proportion) 0.09 [0.04, 0.13] GRADE not reported 7 studies · 140 participants |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · Tongue | Incidence (pooled proportion) 0.25 [0.20, 0.31] GRADE not reported 10 studies · 1383 participants |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · Male | Incidence (pooled proportion) 0.29 [0.24, 0.34] GRADE not reported 19 studies · 4205 participants |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · Gingiva | Incidence (pooled proportion) 0.33 [0.21, 0.45] GRADE not reported 8 studies · 681 participants |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · T1+T2 | Incidence (pooled proportion) 0.26 [0.19, 0.34] GRADE not reported 8 studies |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · Bilateral neck dissection | Incidence (pooled proportion) 0.48 [0.28, 0.69] GRADE not reported 7 studies · 183 participants |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · No neck dissection | Incidence (pooled proportion) 0.67 [0.58, 0.77] GRADE not reported 7 studies · 2252 participants |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery | Incidence (pooled proportion) 0.29 [0.25, 0.33] GRADE not reported 21 studies · 6071 participants |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · Floor of mouth | Incidence (pooled proportion) 0.33 [0.24, 0.41] GRADE not reported 9 studies · 342 participants |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · Clinical stage III-IV | Incidence (pooled proportion) 0.34 [0.26, 0.42] GRADE not reported 10 studies · 1254 participants |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · Female | Incidence (pooled proportion) 0.25 [0.20, 0.30] GRADE not reported 18 studies · 1391 participants |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · Free flap | Incidence (pooled proportion) 0.32 [0.24, 0.40] GRADE not reported 8 studies · 921 participants |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · T3+T4 | Incidence (pooled proportion) 0.42 [0.31, 0.54] GRADE not reported 8 studies · 902 participants |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · Unilateral neck dissection | Incidence (pooled proportion) 0.35 [0.10, 0.60] GRADE not reported 5 studies · 538 participants |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · N(-) | Incidence (pooled proportion) 0.37 [0.25, 0.49] GRADE not reported 7 studies · 688 participants |
| Not applicable (single-group incidence) | Not applicable | Surgical site infection (SSI) incidence Postoperative · Oral cancer surgery · Local flap | Incidence (pooled proportion) 0.16 [0.06, 0.26] GRADE not reported 4 studies · 725 participants |
| Male sex | Female sex | Surgical site infection (SSI) Postoperative · Oral cancer surgery | OR 1.44 [0.68, 3.05] GRADE not reported 5 studies |
| Radiotherapy (preoperative, postoperative or unspecified prior) | No radiotherapy | Surgical site infection (SSI) Postoperative · Oral cancer surgery | OR 1.81 [1.16, 2.85] GRADE not reported 5 studies |
| Mandibulectomy | No mandibulectomy | Surgical site infection (SSI) Postoperative · Oral cancer surgery | OR 2.82 [2.00, 3.98] GRADE not reported 5 studies |
| Diabetes | No diabetes | Surgical site infection (SSI) Postoperative · Oral cancer surgery | OR 3.18 [1.87, 5.40] GRADE not reported 6 studies |
| Higher BMI (as defined by included studies) | Lower BMI | Surgical site infection (SSI) Postoperative · Oral cancer surgery | OR 2.13 [0.93, 4.87] GRADE not reported 3 studies |
| Higher ASA classification | Lower ASA classification | Surgical site infection (SSI) Postoperative · Oral cancer surgery | OR 1.40 [1.23, 1.60] GRADE not reported 4 studies |
| Higher ACE-27 comorbidity score | Lower ACE-27 comorbidity score | Surgical site infection (SSI) Postoperative · Oral cancer surgery | OR 1.01 [0.60, 1.71] GRADE not reported 3 studies |
| Operative time 6 h or longer (categorical) | Operative time under 6 h | Surgical site infection (SSI) Postoperative · Oral cancer surgery | OR 4.17 [2.17, 7.99] GRADE not reported 5 studies |
| Reconstructive surgery | No reconstructive surgery | Surgical site infection (SSI) Postoperative · Oral cancer surgery | OR 4.10 [2.10, 7.99] GRADE not reported 5 studies |
| Tracheostomy | No tracheostomy | Surgical site infection (SSI) Postoperative · Oral cancer surgery | OR 1.63 [0.61, 4.32] GRADE not reported 3 studies |
| Blood transfusion | No blood transfusion | Surgical site infection (SSI) Postoperative · Oral cancer surgery | OR 3.18 [1.56, 6.48] GRADE not reported 6 studies |
| Neck dissection | No neck dissection | Surgical site infection (SSI) Postoperative · Oral cancer surgery | OR 1.93 [1.09, 3.40] GRADE not reported 3 studies |
| Lower skeletal muscle index (SMI) | Higher skeletal muscle index | Surgical site infection (SSI) Postoperative · Oral cancer surgery | OR 1.99 [0.79, 4.98] GRADE not reported 2 studies |
| Lower serum albumin (hypoalbuminemia) | Normal serum albumin | Surgical site infection (SSI) Postoperative · Oral cancer surgery | OR 2.20 [1.07, 4.53] GRADE not reported 2 studies |
Included primary studies 21
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Belusic-Gobic, 2018 Multivariate analysis of risk factors for postoperative wound infection following oral and oropharyngeal cancer surgery. PMID:29203089 | 2018 | this review only | not stated | not extracted yet |
| Eder-Czembirek, 2016 Surgical site infection in clean-contaminated wounds after multimodal treatment of advanced oral squamous cell carcinoma. PMID:27810163 | 2016 | this review only | not stated | not extracted yet |
| Elfayeg, 2024 Frequency and Risk Factors of Surgical Site Infection among Sudanese Patients with Oral Squamous Cell Carcinoma. PMID:38361763 | 2024 | this review only | not stated | not extracted yet |
| Fujii, 2024 Impact of skeletal muscle mass on postoperative complications in oral cancer surgery. PMID:38538802 | 2024 | this review only | not stated | not extracted yet |
| Hiraoka, 2022 Preoperative nutritional evaluation, surgical site infection, and prognosis in patients with oral cancer. PMID:35430178 | 2022 | this review only | not stated | not extracted yet |
| Karakida, 2010 Analysis of risk factors for surgical-site infections in 276 oral cancer surgeries with microvascular free-flap reconstructions at a… PMID:20809241 | 2010 | this review only | not stated | not extracted yet |
| Karthik, 2021 Predictors of surgical site infection and pneumonia following oral cavity tumor surgery. PMID:34227171 | 2021 | this review only | not stated | not extracted yet |
| Lee, 2015 Postoperative hypoalbuminemia as a risk factor for surgical site infection after oral cancer surgery. PMID:24605906 | 2015 | this review only | not stated | not extracted yet |
| Lin, 2012 The association between surgical site infection and previous operation in oral cavity cancer patients. PMID:21779839 | 2012 | this review only | not stated | not extracted yet |
| Lin, 2018 Factors contributing to surgical site infection in patients with oral cancer undergoing microvascular free flap reconstruction. PMID:29948267 | 2018 | this review only | not stated | not extracted yet |
| Liu, 2007 Risk factors for wound infection after surgery in primary oral cavity cancer patients. PMID:17202947 | 2007 | this review only | not stated | not extracted yet |
| Liu, 2011 Surgical site infection after preoperative neoadjuvant chemotherapy in patients with locally advanced oral squamous cell carcinoma. PMID:21674671 | 2011 | this review only | not stated | not extracted yet |
| Ma, 2012 Surgical site infection in elderly oral cancer patients: is the evaluation of comorbid conditions helpful in the identification of… PMID:22265170 | 2012 | this review only | not stated | not extracted yet |
| Makiguchi, 2019 (ref 15) Risk Factors for Surgical Site Infection in Patients Undergoing Free and Pedicled Myocutaneous Flap Reconstruction After Oral Cancer… PMID:30707981 | 2019 | this review only | not stated | not extracted yet |
| Makiguchi, 2019 (ref 16) Impact of skeletal muscle mass volume on surgical site infection in free flap reconstruction for oral cancer. PMID:31328303 | 2019 | this review only | not stated | not extracted yet |
| Nakamura, 2020 Impact of sarcopenia on postoperative surgical site infections in patients undergoing flap reconstruction for oral cancer. PMID:31601472 | 2020 | this review only | not stated | not extracted yet |
| Sato, 2011 Oral health care reduces the risk of postoperative surgical site infection in inpatients with oral squamous cell carcinoma. PMID:20232086 | 2011 | this review only | not stated | not extracted yet |
| Shen, 2023 Risk factors for the occurrence of infection in patients with oral squamous cell carcinoma after restorative reconstruction and its impact… PMID:37701120 | 2023 | this review only | not stated | not extracted yet |
| Shi, 2020 Risk factors for surgical site infection after major oral oncological surgery: the experience of a tertiary referral hospital in China. PMID:32841576 | 2020 | this review only | not stated | not extracted yet |
| Wang, 2016 [Study of the risk factors of postoperative surgical site infection in geriatric patients with oral squamous cell carcinoma]. PMID:27337928 | 2016 | this review only | not stated | not extracted yet |
| Yao, 2017 Surgical site infections following oral cavity cancer resection and reconstruction is a risk factor for plate exposure. PMID:28390434 | 2017 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients diagnosed with oral cancer who underwent surgical treatment | Patients with oral cancer undergoing surgery (n=6071) |
| Intervention | Potential risk factors for SSI (exposures) | Radiotherapy, mandibulectomy, diabetes, BMI, ASA classification, ACE-27, operative time, reconstructive surgery, tracheostomy, transfusion, neck dissection, lower SMI, albumin, male sex |
| Comparison | Not specified | Not specified |
| Outcomes | Surgical site infection (incidence; odds ratios for influencing factors) | SSI (1514 events); pooled incidence 29% (95% CI 25%-33%) |
| Study designs | Observational studies (cohort or case-control), English full text | 21 studies (17 retrospective cohort, 3 case-control, 1 prospective cohort) |
| Timing | Not specified | Treatment 1977 to 2023; studies published 2007 to 2024 |