Department of Surgery, Dentistry, Gynecology, and Pediatrics, Division of Otorhinolaryngology, University of Verona, University Hospital of Verona, Borgo Trento, Piazzale Aristide Stefani, Verona, Italy.
Department of Experimental and Clinical Medicine, University of Florence, AOU-Careggi, Florence, Italy.
J Surg Oncol. 2021 Oct;124(5):740-750. doi: 10.1002/jso.26576. Epub 2021 Jun 21.
The current evidence regarding complications after salvage neck dissection (ND) for isolated regional recurrences (IRRs) in head and neck cancers is poor. The aim of this study is to evaluate the incidence and differences in complication rates of salvage ND after primary surgery, radiotherapy, chemoradiotherapy, or combined treatments.
This was a multicentric retrospective study on 64 patients who underwent salvage ND for IRR in three Italian institutes between 2008 and May 2020.
Complications were detected in 7 of the 34 patients (20.8%) and surgeons described difficult dissection in 20 patients (58.82%). Accidental vascular ligations or nervous injury during surgery were never detected. None of the variables analyzed were statistically significant in predicting the risk of complications, disease-free survival, or overall survival.
IRR represents a rare entity among total relapses. The incidence of complications after salvage ND for IRR is higher than after primary surgery but at an acceptable rate in experienced hands. However, an adequate balance between functional and oncological outcomes is mandatory.
目前关于头颈部癌症孤立区域性复发(IRR)患者行挽救性颈清扫术(ND)后并发症的数据有限。本研究旨在评估在原发手术后、放疗后、放化疗后或联合治疗后行挽救性 ND 的并发症发生率和差异。
这是一项在意大利的三家机构进行的多中心回顾性研究,纳入了 2008 年至 2020 年 5 月期间因 IRR 而行挽救性 ND 的 64 名患者。
34 名患者中有 7 名(20.8%)出现了并发症,20 名(58.82%)术者描述了困难的解剖。术中从未发现意外的血管结扎或神经损伤。在预测并发症、无疾病生存或总生存的风险方面,所分析的变量均无统计学意义。
IRR 在所有复发中属于罕见情况。挽救性 ND 治疗 IRR 的并发症发生率高于原发手术后,但在经验丰富的医生手中并发症发生率处于可接受水平。然而,在功能和肿瘤学结果之间需要取得适当的平衡。