Carotid artery resection for cancer of the head and neck.

OBJECTIVE

To compare the morbidity and mortality associated with ligation and reconstruction of the carotid artery after resection.

DESIGN

Cohort study.

SETTING

Tertiary referral center and Veterans Affairs medical center.

PATIENTS

Twenty consecutive patients who underwent carotid artery resection for metastatic squamous cell carcinoma between January 1985 and June 1992.

RESULTS

Seven (58%) of 12 patients with ligation suffered neurological sequelae compared with one (13%) of eight patients with interposition grafts (P < .05). Six of eight patients with neurological sequelae had delayed onset of complications. Local control of tumor was achieved in 14 (74%) of 19 patients overall. Median survival was 6.3 months, and the 1-year disease-free survival rate was 16% (three patients).

CONCLUSION

Carotid artery replacement is superior to ligation in avoiding the neurological complications of carotid artery resection. Carotid artery resection can provide local control of tumor but fails to achieve a high rate of disease-free survival.