Cargando…
Assessment of peri- and postoperative complications and Karnofsky-performance status in head and neck cancer patients after radiation or chemoradiation that underwent surgery with regional or free-flap reconstruction for salvage, palliation, or to improve function
BACKGROUND: Surgery after (chemo)radiation (RCTX/RTX) is felt to be plagued with a high incidence of wound healing complications reported to be as high as 70%. The additional use of vascularized flaps may help to decrease this high rate of complications. Therefore, we examined within a retrospective...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2011
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179945/ https://www.ncbi.nlm.nih.gov/pubmed/21896171 http://dx.doi.org/10.1186/1748-717X-6-109 |
_version_ | 1782212573290037248 |
---|---|
author | Simon, Christian Bulut, Cem Federspil, Philippe A Münter, Marc W Lindel, Katja Bergmann, Zazie Sertel, Serkan Leitzbach, Sarah Plinkert, Peter K |
author_facet | Simon, Christian Bulut, Cem Federspil, Philippe A Münter, Marc W Lindel, Katja Bergmann, Zazie Sertel, Serkan Leitzbach, Sarah Plinkert, Peter K |
author_sort | Simon, Christian |
collection | PubMed |
description | BACKGROUND: Surgery after (chemo)radiation (RCTX/RTX) is felt to be plagued with a high incidence of wound healing complications reported to be as high as 70%. The additional use of vascularized flaps may help to decrease this high rate of complications. Therefore, we examined within a retrospective single-institutional study the peri--and postoperative complications in patients who underwent surgery for salvage, palliation or functional rehabilitation after (chemo)radiation with regional and free flaps. As a second study end point the Karnofsky performance status (KPS) was determined preoperatively and 3 months postoperatively to assess the impact of such extensive procedures on the overall performance status of this heavily pretreated patient population. FINDINGS: 21 patients were treated between 2005 and 2010 in a single institution (17 male, 4 female) for salvage (10/21), palliation (4/21), or functional rehabilitation (7/21). Overall 23 flaps were performed of which 8 were free flaps. Major recipient site complications were observed in only 4 pts. (19%) (1 postoperative haemorrhage, 1 partial flap loss, 2 fistulas) and major donor site complications in 1 pt (wound dehiscence). Also 2 minor donor site complications were observed. The overall complication rate was 33%. There was no free flap loss. Assessment of pre- and postoperative KPS revealed improvement in 13 out of 21 patients (62%). A decline of KPS was noted in only one patient. CONCLUSIONS: We conclude that within this (chemo)radiated patient population surgical interventions for salvage, palliation or improve function can be safely performed once vascularised grafts are used. |
format | Online Article Text |
id | pubmed-3179945 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-31799452011-09-26 Assessment of peri- and postoperative complications and Karnofsky-performance status in head and neck cancer patients after radiation or chemoradiation that underwent surgery with regional or free-flap reconstruction for salvage, palliation, or to improve function Simon, Christian Bulut, Cem Federspil, Philippe A Münter, Marc W Lindel, Katja Bergmann, Zazie Sertel, Serkan Leitzbach, Sarah Plinkert, Peter K Radiat Oncol Short Report BACKGROUND: Surgery after (chemo)radiation (RCTX/RTX) is felt to be plagued with a high incidence of wound healing complications reported to be as high as 70%. The additional use of vascularized flaps may help to decrease this high rate of complications. Therefore, we examined within a retrospective single-institutional study the peri--and postoperative complications in patients who underwent surgery for salvage, palliation or functional rehabilitation after (chemo)radiation with regional and free flaps. As a second study end point the Karnofsky performance status (KPS) was determined preoperatively and 3 months postoperatively to assess the impact of such extensive procedures on the overall performance status of this heavily pretreated patient population. FINDINGS: 21 patients were treated between 2005 and 2010 in a single institution (17 male, 4 female) for salvage (10/21), palliation (4/21), or functional rehabilitation (7/21). Overall 23 flaps were performed of which 8 were free flaps. Major recipient site complications were observed in only 4 pts. (19%) (1 postoperative haemorrhage, 1 partial flap loss, 2 fistulas) and major donor site complications in 1 pt (wound dehiscence). Also 2 minor donor site complications were observed. The overall complication rate was 33%. There was no free flap loss. Assessment of pre- and postoperative KPS revealed improvement in 13 out of 21 patients (62%). A decline of KPS was noted in only one patient. CONCLUSIONS: We conclude that within this (chemo)radiated patient population surgical interventions for salvage, palliation or improve function can be safely performed once vascularised grafts are used. BioMed Central 2011-09-06 /pmc/articles/PMC3179945/ /pubmed/21896171 http://dx.doi.org/10.1186/1748-717X-6-109 Text en Copyright ©2011 Simon et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Short Report Simon, Christian Bulut, Cem Federspil, Philippe A Münter, Marc W Lindel, Katja Bergmann, Zazie Sertel, Serkan Leitzbach, Sarah Plinkert, Peter K Assessment of peri- and postoperative complications and Karnofsky-performance status in head and neck cancer patients after radiation or chemoradiation that underwent surgery with regional or free-flap reconstruction for salvage, palliation, or to improve function |
title | Assessment of peri- and postoperative complications and Karnofsky-performance status in head and neck cancer patients after radiation or chemoradiation that underwent surgery with regional or free-flap reconstruction for salvage, palliation, or to improve function |
title_full | Assessment of peri- and postoperative complications and Karnofsky-performance status in head and neck cancer patients after radiation or chemoradiation that underwent surgery with regional or free-flap reconstruction for salvage, palliation, or to improve function |
title_fullStr | Assessment of peri- and postoperative complications and Karnofsky-performance status in head and neck cancer patients after radiation or chemoradiation that underwent surgery with regional or free-flap reconstruction for salvage, palliation, or to improve function |
title_full_unstemmed | Assessment of peri- and postoperative complications and Karnofsky-performance status in head and neck cancer patients after radiation or chemoradiation that underwent surgery with regional or free-flap reconstruction for salvage, palliation, or to improve function |
title_short | Assessment of peri- and postoperative complications and Karnofsky-performance status in head and neck cancer patients after radiation or chemoradiation that underwent surgery with regional or free-flap reconstruction for salvage, palliation, or to improve function |
title_sort | assessment of peri- and postoperative complications and karnofsky-performance status in head and neck cancer patients after radiation or chemoradiation that underwent surgery with regional or free-flap reconstruction for salvage, palliation, or to improve function |
topic | Short Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179945/ https://www.ncbi.nlm.nih.gov/pubmed/21896171 http://dx.doi.org/10.1186/1748-717X-6-109 |
work_keys_str_mv | AT simonchristian assessmentofperiandpostoperativecomplicationsandkarnofskyperformancestatusinheadandneckcancerpatientsafterradiationorchemoradiationthatunderwentsurgerywithregionalorfreeflapreconstructionforsalvagepalliationortoimprovefunction AT bulutcem assessmentofperiandpostoperativecomplicationsandkarnofskyperformancestatusinheadandneckcancerpatientsafterradiationorchemoradiationthatunderwentsurgerywithregionalorfreeflapreconstructionforsalvagepalliationortoimprovefunction AT federspilphilippea assessmentofperiandpostoperativecomplicationsandkarnofskyperformancestatusinheadandneckcancerpatientsafterradiationorchemoradiationthatunderwentsurgerywithregionalorfreeflapreconstructionforsalvagepalliationortoimprovefunction AT muntermarcw assessmentofperiandpostoperativecomplicationsandkarnofskyperformancestatusinheadandneckcancerpatientsafterradiationorchemoradiationthatunderwentsurgerywithregionalorfreeflapreconstructionforsalvagepalliationortoimprovefunction AT lindelkatja assessmentofperiandpostoperativecomplicationsandkarnofskyperformancestatusinheadandneckcancerpatientsafterradiationorchemoradiationthatunderwentsurgerywithregionalorfreeflapreconstructionforsalvagepalliationortoimprovefunction AT bergmannzazie assessmentofperiandpostoperativecomplicationsandkarnofskyperformancestatusinheadandneckcancerpatientsafterradiationorchemoradiationthatunderwentsurgerywithregionalorfreeflapreconstructionforsalvagepalliationortoimprovefunction AT sertelserkan assessmentofperiandpostoperativecomplicationsandkarnofskyperformancestatusinheadandneckcancerpatientsafterradiationorchemoradiationthatunderwentsurgerywithregionalorfreeflapreconstructionforsalvagepalliationortoimprovefunction AT leitzbachsarah assessmentofperiandpostoperativecomplicationsandkarnofskyperformancestatusinheadandneckcancerpatientsafterradiationorchemoradiationthatunderwentsurgerywithregionalorfreeflapreconstructionforsalvagepalliationortoimprovefunction AT plinkertpeterk assessmentofperiandpostoperativecomplicationsandkarnofskyperformancestatusinheadandneckcancerpatientsafterradiationorchemoradiationthatunderwentsurgerywithregionalorfreeflapreconstructionforsalvagepalliationortoimprovefunction |