The Effects of Preoperative Radiotherapy on Head and Neck Free Flap Anastomosis Success.
OBJECTIVE
The long-term survival benefit of neoadjuvant radiotherapy for oropharyngeal tumors is controversially discussed in the literature. To bring more light into this important debate, we evaluated our cases.


METHODS
In this retrospective study the main focus was the relationship between neoadjuvant irradiation and anastomosis failure. Other influencing factors including previous operative treatment and tumor stage and type also were studied.


RESULTS
In total, 7 anastomoses failed (total failure rate, 8.4%; n = 83); 1 of the 7 underwent neoadjuvant irradiation (failure rate, 3.1%; n = 32). All 7 anastomosis failures were in squamous cell carcinoma cases, with 5 of them staged as T4.


CONCLUSIONS
Our data suggest that neoadjuvant radiotherapy for oropharyngeal carcinoma does not increase the risk of postoperative anastomosis failure compared with surgical reconstruction alone. Furthermore, the data suggest a correlation between the stage and type of tumor.
Resident, Clinic of Cranio-Maxillofacial and Oral Surgery, University Hospital of Zurich, Zurich, Switzerland. Electronic address: Claudio.Rostetter@usz.ch.
Claudio
C
Rostetter
Dental Student, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
Irina M
IM
Kuster
Resident, Department of General Surgery, Limmattal Hospital, Schlieren, Switzerland.
Jan S
JS
Schenkel
Resident, Clinic of Cranio-Maxillofacial and Oral Surgery, University Hospital of Zurich, Zurich, Switzerland.
Martin
M
Lanzer
Consultant, Clinic of Cranio-Maxillofacial and Oral Surgery, University Hospital of Zurich, Zurich, Switzerland.
Thomas
T
Gander
Private Practice, Seestrasse 8, Uster, Switzerland.
Astrid L
AL
Kruse
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy* / Q000601:surgery; D002648:Child; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply*; D006085:Graft Survival / Q000528:radiation effects*; D006801:Humans; D008297:Male; D055806:Microvessels / Q000528:radiation effects / Q000601:surgery*; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D009959:Oropharyngeal Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D017211:Treatment Failure; D055815:Young Adult