Wound Complication in Post-chemoradiotherapy Neck Dissection

Objective: Report the incidence and type of postoperative complications following neck dissection in patients with advanced stage squamous cell cancer of the laryngopharynx treated with chemoradiotherapy (CRT) and to identify factors predictive of these complications. Method: Design: Retrospective review of case series. Setting: Single institution. Patients: Thirty-three patients with advanced laryngopharyngeal cancer who underwent postchemoradiation neck dissection between 2003 and 2007 were identified. Intervention: Neck dissection, with or without resection of the primary site, in patients following chemoradiotherapy. Main outcome measure: postoperative complications. Results: Thirty-eight neck dissections were carried out in 33 patients (median ± SD age, 59 ± 7.8 years; 85% male). Local wound complications were recorded in 6 (18%) of 33 patients with one mortality from carotid rupture. Complications were seen in 1 (17%) of 6 patients with N1 disease, 5 (23%) of 22 patients with N2, and 0 of 5 patients with N3 neck disease. There was no association between type of neck dissection, medical comorbidities, smoking, time interval between completion of chemoradiotherapy and neck dissection, and rate of complications (P > .05). There were no recorded systemic complications following salvage surgery. Conclusion: The incidence of wound complications after neck dissection in patients treated with chemoradiation in our cohort is 18%. This compares favorably to reported literature. Nutritional issues and patients’ co-morbidities should be addressed to minimize wound complications risk.