Complications of total laryngectomy in the era of chemoradiation
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Jan Klozar · Zdenek Cada · Eva Koslabova
- چاپ و سال / کشور: 2011
Description
As more total laryngectomies (TLE) are nowadays performed as salvage procedures, the rate of postoperative complications increases. The primary aim was to report the rates of postoperative local complications for total laryngectomy in patients with previous radiotherapy or chemoradiotherapy (RT/CRT) in comparison with primary TLE data. We attempted to identify patient- and tumor-related factors predictive of postoperative pharyngocutaneous Wstula (PCF) formation. The secondary aims were to analyze the survival rate in relation to postoperative complications and to study prognostic factors of survival in TLE patients. A retrospective study was conducted in 208 patients. Logistic regression was used to determine the most signiWcant risk factors for Wstula formation. Survival was analyzed by the Kaplan–Meier method, log-rank test, and Cox multivariate regression. PCF developed in 20.7% of cases. In the group of patients with previous RT/CRT, the Wstula rate was signiWcantly higher (34%). In multivariate analysis, signiWcant risk factors for Wstula formation were previous radiotherapy or chemoradiotherapy (p = 0.02), higher N classiWcation (p = 0.03), and procedure performed by a less experienced surgeon (p = 0.003). The survival and recurrence rates were not inXuenced by PCF formation. The overall survival rates were lower in patients with previous RT/CRT and in patients with lymph node involvement.
Eur Arch Otorhinolaryngol,Received: 25 January 2011 / Accepted: 29 March 2011 © Springer-Verlag 2011
