High complication risk of salvage surgery after chemoradiation failures.
CONCLUSIONS
Although organ preservation can be achieved with chemoradiation protocols for laryngeal or pharyngeal cancers, salvage surgery is accompanied by high complication rates.


OBJECTIVE
To determine the rate of complications associated with salvage surgery after chemoradiation for laryngeal and pharyngeal cancers.


METHODS
A multicenter retrospective study was performed of 24 patients treated with total laryngectomy combined with total or partial pharyngectomy between 1995 and 2004 who had previously been treated with chemoradiation. The main outcome measures were early and late complication rates. Quality of life analysis was determined by two questionnaires.


RESULTS
The complication rate after salvage surgery was 92% in the direct postoperative period. The most frequent complication was pharyngocutaneous fistula formation. Narrowing of the esophagus and tracheostoma were the most common late sequelae. The quality of life, measured at least 2 years after salvage surgery, showed a social dysfunctioning.
Department of Otolaryngology Head and Neck Surgery, Erasmus Medical Center Rotterdam, The Netherlands. a.sewnaik@erasmusmc.nl
Aniel
A
Sewnaik
Stijn
S
Keereweer
Abrahim
A
Al-Mamgani
Robert J
RJ
Baatenburg de Jong
Marjan H
MH
Wieringa
Cees A
CA
Meeuwis
Jeroen D F
JD
Kerrebijn
D000368:Aged; D059248:Chemoradiotherapy / Q000009:adverse effects*; D017577:Cutaneous Fistula / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D007822:Laryngeal Neoplasms / Q000628:therapy; D007825:Laryngectomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010611:Pharyngectomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D016879:Salvage Therapy / Q000009:adverse effects* / Q000379:methods; D013524:Surgical Flaps; D017211:Treatment Failure