Patient Profiles From Head and Neck Cancer Surgery in North London

Objectives: Understanding the clinical and treatment profiles of patients undergoing head and neck (H&N) cancer surgery is essential for identifying inequalities and improving outcomes. This study describes patients treated at University College London Hospitals (UCLH), a specialist centre serving the North-East and North-Central London Cancer Alliances.
Methods: This descriptive analysis used data from the Quality Outcomes in Oral and Maxillofacial Surgery (QOMS) database. A total of 381 patients who underwent surgery for H&N cancer between April 2021 and May 2024 were included. Variables analysed included socio-demographics (age, sex, Index of Multiple Deprivation [IMD]), behavioural factors (smoking, alcohol intake), clinical factors (BMI, diabetes, vascular arteriopathy, cancer diagnosis, previous H&N treatments), treatment-related variables (scale of surgery, neck dissection, reconstruction, histopathology), and post-operative outcomes.
Results: The patient population had a mean age of 62.5 years (SD 14.2) and a median age of 62.5 years (IQR 54–73), with 54.0% aged 61–80 years. The cohort was 61.9% male, and 16.8% were from the most deprived IMD quintile. Most patients (85.0%) had squamous cell carcinoma, with 96.9% presenting untreated primary tumours. Behavioural data showed 43.0% had never smoked, 18.9% were current smokers, and 45.1% reported no alcohol consumption. Clinically, 37.3% had a normal BMI, 17.9% were obese, 18.1% had diabetes, 7.9% had vascular arteriopathy, and 5.5% had prior H&N radiotherapy. Major surgery (>6 hours or requiring free tissue transfer) was performed in 54.3% of cases, with neck dissection in 67.2% and flap reconstruction in 56.4% (81.4% free flaps). Post-operatively, 46.7% experienced complications, with Clavien-Dindo grade II most common (18.6%).
Conclusions: This study highlights the diverse profiles of patients undergoing H&N cancer surgery, emphasizing behavioural and clinical risk factors and surgical complexity. These findings provide a foundation for research addressing inequalities and improving outcomes.