# Risk factors associated with prognosis in patients with osteoradionecrosis of the jaws: A single institutional experience over 15 years

## TL;DR

This study identifies risk factors affecting the prognosis of jaw osteoradionecrosis in cancer patients over 15 years at a single hospital.

## Contribution

The study provides new insights into clinical risk factors for poor outcomes in osteoradionecrosis patients.

## Key findings

- Diabetes, comorbidity index, and immune-inflammatory indices are significant risk factors for poor prognosis.
- Initial ORNJ grade and tumor stage also strongly correlate with clinical outcomes.
- Early evaluation of these factors can guide post-radiation treatment planning.

## Abstract

Osteoradionecrosis of the jaws (ORNJ) is a pernicious complication of radiation therapy that significantly affects the quality of life of patients with head and neck cancer. The present study aimed to investigate the risk factors for the clinical prognosis of ORNJ in the same scenario.

A cross-sectional study was designed and implemented in a tertiary teaching hospital from January 2005 to December 2020. A total of 106 patients were divided into normal wound healing group (n = 79) and delayed wound healing group (n = 27) according to two different prognosis. The risk factors associated with the prognosis in patients with ORNJ were comparatively analyzed via performing one-way and multifactorial logistic analyses.

The majority of the study cohort (n = 59, 55.7%) was found to be characterized with Glanzmann and Gratz grade 2 and followed up for a median of 38.6 months. Diabetes mellitus (P = .045), Charlson comorbidity index (P = .042), American Society of Anesthesiologists score (P < .001), primary tumour site (P = .012), T stage (P = .008), ORNJ grade at initial diagnosis (P < .001), pan-immune-inflammatory value and systemic immune-inflammatory index at initial radiotherapy (P = .01 and P < .001 respectively) were detected as risk factors associated with poor prognosis in patients with ORNJ.

We conclude that there are abundant risk factors for poor prognosis in these patients, and it is important to be evaluated before irradiation so that suiTable post-radiated treatments can be given.

Key words:Pan-immune-inflammatory value, systemic immune-inflammatory index, jaw, osteoradionecrosis, clinical prognosis.