 |
|
Comparison of Surgical Complications After Organ-Preservation Therapy in Patients With Stage III or IV Squamous Cell Head and Neck Cancer
Pierre Lavertu, MD;
Joseph P. Bonafede, MD;
David J. Adelstein, MD;
Jerrold P. Saxton, MD;
Marshall Strome, MD;
John R. Wanamaker, MD;
Isaac Eliachar, MD;
Benjamin G. Wood, MD
Arch Otolaryngol Head Neck Surg. 1998;124:401-406.
Objective To determine the incidence of minor and major complications in patients with squamous cell carcinoma of the upper aerodigestive tract who require surgical salvage or planned neck dissection after an initial treatment regimen with radiotherapy or concurrent chemoradiotherapy for organ preservation.
Design The medical records of 100 patients treated in a phase 3 trial comparing radiotherapy alone with concurrent chemoradiotherapy for stage III and IV head and neck squamous cell carcinoma were reviewed. Fifty-four patients underwent 59 surgical procedures. Twenty-nine planned neck dissections were performed for persistent neck disease or initial stage N2 or greater. For persistent or recurrent disease at the primary site, 30 salvage operations were performed.
Setting Academic tertiary care referral center.
Results Complications occurred in 15 (46%) of the 33 procedures in the radiation-only group and 12 (46%) of the 26 procedures in the chemoradiotherapy group. Major complications occurred in 4 (12%) of the procedures in the radiation-only group and 3 (12%) of the procedures in the chemoradiotherapy group. The incidence of minor complications was 33% and 35% in the radiation-only and chemoradiotherapy groups, respectively. The major complication rate for salvage operations did not differ between the radiation-only and chemoradiotherapy groups (16% and 27%, respectively; P=.79 by  2test). The incidence of major complications in planned neck dissections was 7% of the radiation-only group and 0% of the chemoradiotherapy group.
Conclusions After radiation or concurrent chemoradiotherapy, surgery can be performed with an acceptable rate of major complications. Adding chemotherapy did not increase the incidence of surgical complications. These results differ from other reports in the literature.
From the Departments of Otolaryngology (Drs Lavertu, Bonafede, Strome, Eliachar, and Wood), Hematology and Medical Oncology (Dr Adelstein), and Radiation Oncology (Dr Saxton), Cleveland Clinic Foundation, Cleveland, Ohio, and Central New York Ear Nose and Throat Consultants, Syracuse (Dr Wanamaker).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Ability of Positron Emission Tomography to Detect Residual Neck Node Disease in Patients With Head and Neck Squamous Cell Carcinoma After Definitive Chemoradiotherapy
Tan et al.
Arch Otolaryngol Head Neck Surg 2007;133:435-440.
ABSTRACT
| FULL TEXT
Surgical Wound Complications After Intensive Chemoradiotherapy for Advanced Squamous Cell Carcinoma of the Head and Neck
Morgan et al.
Arch Otolaryngol Head Neck Surg 2007;133:10-14.
ABSTRACT
| FULL TEXT
American Society of Clinical Oncology Clinical Practice Guideline for the Use of Larynx-Preservation Strategies in the Treatment of Laryngeal Cancer
Pfister et al.
JCO 2006;24:3693-3704.
ABSTRACT
| FULL TEXT
Postoperative Complications After En Bloc Salvage Surgery for Head and Neck Cancer
Agra et al.
Arch Otolaryngol Head Neck Surg 2003;129:1317-1321.
ABSTRACT
| FULL TEXT
Outcome of Salvage Total Laryngectomy Following Organ Preservation Therapy: The Radiation Therapy Oncology Group Trial 91-11
Weber et al.
Arch Otolaryngol Head Neck Surg 2003;129:44-49.
ABSTRACT
| FULL TEXT
The Role of Cervical Lymphadenectomy After Aggressive Concomitant Chemoradiotherapy: The Feasibility of Selective Neck Dissection
Stenson et al.
Arch Otolaryngol Head Neck Surg 2000;126:950-956.
ABSTRACT
| FULL TEXT
|
