{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T22:48:45Z","timestamp":1784069325581,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T00:00:00Z","timestamp":1738800000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Complications of oral cavity cancer (OCC) surgery have an impact on the quality of life. Therefore, evaluating hospital performance on complication rates can help identify best practices for improving the quality of OCC care. As patient and tumor characteristics also impact hospital results, case\u2010mix adjustment should be considered to provide a valid hospital comparison. This study investigated hospital variation in the quality indicator \u201ca complicated postoperative course\u201d after OCC surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This population\u2010based cohort included all first primary OCC patients diagnosed between 2018 and 2021 who were surgically treated with curative intent. A complicated postoperative course was defined as 30\u2010day mortality, unplanned readmission, surgical complications requiring reintervention or prolonged hospital stay, or fistula formation. Hospital performance was analyzed using funnel plots with case\u2010mix correction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 2,266 OCC patients could be included. The distribution of case\u2010mix variables varied significantly between hospital populations. Nationally, a complicated postoperative course occurred in 13.9% and uncorrected hospital rates ranged from 2.7% to 31.1%. A WHO performance score\u2009\u22652, cT3\u2010T4 tumors, and floor\u2010of\u2010mouth tumors were associated with an increased risk of a complicated postoperative course, and non\u2010squamous cell carcinoma with a decreased risk. Significant outliers remained after case\u2010mix correction for patient, tumor, and treatment characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Complications after OCC surgery are prevalent, especially regarding extensive tumors and surgery. To identify best practices in OCC surgery, hospital performance on a complicated postoperative course should be adjusted for case\u2010mix and treatment variables. Providing feedback on hospital performance for complications can instigate improvement plans for better outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      3\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 135:2411\u20132419, 2025\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.32033","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T04:39:44Z","timestamp":1738816784000},"page":"2411-2419","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Surgical Complications for Oral Cavity Cancer: Evaluating Hospital Performance"],"prefix":"10.1002","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6858-3984","authenticated-orcid":false,"given":"Hanneke Doremiek","family":"van Oorschot","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery Erasmus Medical Centre Cancer Institute  Rotterdam The Netherlands"},{"name":"Scientific Bureau Dutch Institute for Clinical Auditing  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5580-5613","authenticated-orcid":false,"given":"Jose Angelito","family":"Hardillo","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery Erasmus Medical Centre Cancer Institute  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.J.","family":"van Es","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgical Oncology UMC Utrecht Cancer Centre  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido B.","family":"van den Broek","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4784-0499","authenticated-orcid":false,"given":"Robert Paul","family":"Takes","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2460-2260","authenticated-orcid":false,"given":"Gyorgy Bela","family":"Halmos","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\/Head and Neck Surgery, University Medical Centre Groningen University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8159-0089","authenticated-orcid":false,"given":"Dominique Valerie Clarence","family":"de Jel","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\/Head and Neck Surgery, University Medical Centre Groningen University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Dirven","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Oncology and Surgery Netherlands Cancer Institute\/Antoni van Leeuwenhoek  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2868-4822","authenticated-orcid":false,"given":"Martin","family":"Lacko","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, GROW School for Oncology and Reproduction Maastricht University Medical Center  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1408-6146","authenticated-orcid":false,"given":"Lauretta Anna Alexandra","family":"Vaassen","sequence":"additional","affiliation":[{"name":"Department of Cranio\u2010maxillofacial surgery, GROW School for Oncology and Reproduction Maastricht University Medical Center  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan\u2010Jaap","family":"Hendrickx","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, Academic Medical Center University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1526-559X","authenticated-orcid":false,"given":"Marjolijn Abigal Eva\u2010Maria","family":"Oomens","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Rijnstate Hospital  Arnhem The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8013-9138","authenticated-orcid":false,"given":"Hossein","family":"Ghaeminia","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Rijnstate Hospital  Arnhem The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen C.","family":"Jansen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6702-4360","authenticated-orcid":false,"given":"Annemarie","family":"Vesseur","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Elisabeth Tweesteden Ziekenhuis Tilburg  Tilburg The 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