Impact of preoperative radiotherapy on head and neck free flap reconstruction: A report on 429 cases
Summary Background The primary objective of this study was to evaluate the impact of preoperative radiotherapy on the outcomes of head and neck microvascular reconstruction. The secondary objective was to assess the specific effects of irradiation doses (IDs) ≥60 Gy on the outcomes of head and neck...
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| Veröffentlicht in: | Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2013-04, Vol.66 (4), p.478-482 |
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| creator | Benatar, M.J Dassonville, O Chamorey, E Poissonnet, G Ettaiche, M Pierre, C.S Benezery, K Hechema, R Demard, F Santini, J Bozec, A |
| description | Summary Background The primary objective of this study was to evaluate the impact of preoperative radiotherapy on the outcomes of head and neck microvascular reconstruction. The secondary objective was to assess the specific effects of irradiation doses (IDs) ≥60 Gy on the outcomes of head and neck microvascular reconstruction. Methods All patients who underwent head and neck free-flap reconstruction in our institution between 2000 and 2010 were included in this retrospective study. A total of 429 patients were enrolled including 136 patients previously irradiated on the head and neck. The impact of preoperative radiotherapy on free-flap success, local and general complications, postoperative mortality, time of decannulation, duration of enteral nutrition and length of stay was assessed in univariate and multivariate analyses. Results In multivariate analysis, preoperative radiotherapy (irrespective of ID) was a significant risk factor for fistula formation ( p = 0.003) and wound infection ( p = 0.005). Previous neck irradiation at doses ≥60 Gy was associated with an increased risk of free-flap failure ( p = 0.04), overall local complications ( p = 0.05), haematoma ( p = 0.04) and longer duration of enteral nutrition ( p = 0.006) and hospital stay ( p = 0.004). Conclusions Preoperative radiotherapy, particularly for ID ≥ 60 Gy, is one of the main determinants of the outcomes of head and neck microvascular reconstruction. |
| doi_str_mv | 10.1016/j.bjps.2012.12.019 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1319184793</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S1748681512007395</els_id><sourcerecordid>1319184793</sourcerecordid><originalsourceid>FETCH-LOGICAL-c411t-f2bf4636c91ed6d7bc564b6240e6b1ccbd75691ca795846b467f669c7e0cc4423</originalsourceid><addsrcrecordid>eNp9kcFrFTEQxhdRbK3-Ax4kRy_7zCTZ7EZEKEVroeBBPYfsZJbmdd9mTXYL7783y6sePBQGZhK-74P5TVW9Bb4DDvrDftfv57wTHMSuFAfzrDqHru1q3kjzvMyt6mrdQXNWvcp5z7mSoJqX1ZmQshFdp84rf3OYHS4sDmxOFGdKbgkPxJLzIS535TkfWZzYHTnP3OTZRHjPhkTEhtHNLBHGKS9pxSXE6SO7LD9zTMvmUcIwdJny6-rF4MZMbx77RfXr65efV9_q2-_XN1eXtzUqgKUeRD8oLTUaIK9922OjVa-F4qR7QOx922gD6FrTdEr3SreD1gZb4ohKCXlRvT_lzin-Xikv9hAy0ji6ieKaLUgw0KnWyCIVJymmmHOiwc4pHFw6WuB2o2v3dqNrN7q2VKFbTO8e89f-QP6f5S_OIvh0ElDZ8iFQshkDTUg-FFCL9TE8nf_5PzuOYQroxns6Ut7HNU2FnwWbi8H-2O67nRcE5600jfwDRt-gDw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1319184793</pqid></control><display><type>article</type><title>Impact of preoperative radiotherapy on head and neck free flap reconstruction: A report on 429 cases</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Benatar, M.J ; Dassonville, O ; Chamorey, E ; Poissonnet, G ; Ettaiche, M ; Pierre, C.S ; Benezery, K ; Hechema, R ; Demard, F ; Santini, J ; Bozec, A</creator><creatorcontrib>Benatar, M.J ; Dassonville, O ; Chamorey, E ; Poissonnet, G ; Ettaiche, M ; Pierre, C.S ; Benezery, K ; Hechema, R ; Demard, F ; Santini, J ; Bozec, A</creatorcontrib><description>Summary Background The primary objective of this study was to evaluate the impact of preoperative radiotherapy on the outcomes of head and neck microvascular reconstruction. The secondary objective was to assess the specific effects of irradiation doses (IDs) ≥60 Gy on the outcomes of head and neck microvascular reconstruction. Methods All patients who underwent head and neck free-flap reconstruction in our institution between 2000 and 2010 were included in this retrospective study. A total of 429 patients were enrolled including 136 patients previously irradiated on the head and neck. The impact of preoperative radiotherapy on free-flap success, local and general complications, postoperative mortality, time of decannulation, duration of enteral nutrition and length of stay was assessed in univariate and multivariate analyses. Results In multivariate analysis, preoperative radiotherapy (irrespective of ID) was a significant risk factor for fistula formation ( p = 0.003) and wound infection ( p = 0.005). Previous neck irradiation at doses ≥60 Gy was associated with an increased risk of free-flap failure ( p = 0.04), overall local complications ( p = 0.05), haematoma ( p = 0.04) and longer duration of enteral nutrition ( p = 0.006) and hospital stay ( p = 0.004). Conclusions Preoperative radiotherapy, particularly for ID ≥ 60 Gy, is one of the main determinants of the outcomes of head and neck microvascular reconstruction.</description><identifier>ISSN: 1748-6815</identifier><identifier>EISSN: 1878-0539</identifier><identifier>DOI: 10.1016/j.bjps.2012.12.019</identifier><identifier>PMID: 23352884</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Comorbidity ; Complications ; Enteral Nutrition ; Female ; Free flap ; Free Tissue Flaps ; Head and neck cancer ; Head and Neck Neoplasms - epidemiology ; Head and Neck Neoplasms - radiotherapy ; Head and Neck Neoplasms - surgery ; Head and neck reconstruction ; Humans ; Length of Stay ; Male ; Middle Aged ; Mouth Neoplasms - epidemiology ; Mouth Neoplasms - surgery ; Neoadjuvant Therapy ; Pharyngeal Neoplasms - epidemiology ; Pharyngeal Neoplasms - radiotherapy ; Pharyngeal Neoplasms - surgery ; Plastic Surgery ; Radiotherapy ; Radiotherapy Dosage ; Radiotherapy, Adjuvant ; Reconstructive Surgical Procedures ; Treatment Outcome ; Young Adult</subject><ispartof>Journal of plastic, reconstructive & aesthetic surgery, 2013-04, Vol.66 (4), p.478-482</ispartof><rights>British Association of Plastic, Reconstructive and Aesthetic Surgeons</rights><rights>2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons</rights><rights>Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-f2bf4636c91ed6d7bc564b6240e6b1ccbd75691ca795846b467f669c7e0cc4423</citedby><cites>FETCH-LOGICAL-c411t-f2bf4636c91ed6d7bc564b6240e6b1ccbd75691ca795846b467f669c7e0cc4423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1748681512007395$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23352884$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Benatar, M.J</creatorcontrib><creatorcontrib>Dassonville, O</creatorcontrib><creatorcontrib>Chamorey, E</creatorcontrib><creatorcontrib>Poissonnet, G</creatorcontrib><creatorcontrib>Ettaiche, M</creatorcontrib><creatorcontrib>Pierre, C.S</creatorcontrib><creatorcontrib>Benezery, K</creatorcontrib><creatorcontrib>Hechema, R</creatorcontrib><creatorcontrib>Demard, F</creatorcontrib><creatorcontrib>Santini, J</creatorcontrib><creatorcontrib>Bozec, A</creatorcontrib><title>Impact of preoperative radiotherapy on head and neck free flap reconstruction: A report on 429 cases</title><title>Journal of plastic, reconstructive & aesthetic surgery</title><addtitle>J Plast Reconstr Aesthet Surg</addtitle><description>Summary Background The primary objective of this study was to evaluate the impact of preoperative radiotherapy on the outcomes of head and neck microvascular reconstruction. The secondary objective was to assess the specific effects of irradiation doses (IDs) ≥60 Gy on the outcomes of head and neck microvascular reconstruction. Methods All patients who underwent head and neck free-flap reconstruction in our institution between 2000 and 2010 were included in this retrospective study. A total of 429 patients were enrolled including 136 patients previously irradiated on the head and neck. The impact of preoperative radiotherapy on free-flap success, local and general complications, postoperative mortality, time of decannulation, duration of enteral nutrition and length of stay was assessed in univariate and multivariate analyses. Results In multivariate analysis, preoperative radiotherapy (irrespective of ID) was a significant risk factor for fistula formation ( p = 0.003) and wound infection ( p = 0.005). Previous neck irradiation at doses ≥60 Gy was associated with an increased risk of free-flap failure ( p = 0.04), overall local complications ( p = 0.05), haematoma ( p = 0.04) and longer duration of enteral nutrition ( p = 0.006) and hospital stay ( p = 0.004). Conclusions Preoperative radiotherapy, particularly for ID ≥ 60 Gy, is one of the main determinants of the outcomes of head and neck microvascular reconstruction.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Comorbidity</subject><subject>Complications</subject><subject>Enteral Nutrition</subject><subject>Female</subject><subject>Free flap</subject><subject>Free Tissue Flaps</subject><subject>Head and neck cancer</subject><subject>Head and Neck Neoplasms - epidemiology</subject><subject>Head and Neck Neoplasms - radiotherapy</subject><subject>Head and Neck Neoplasms - surgery</subject><subject>Head and neck reconstruction</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mouth Neoplasms - epidemiology</subject><subject>Mouth Neoplasms - surgery</subject><subject>Neoadjuvant Therapy</subject><subject>Pharyngeal Neoplasms - epidemiology</subject><subject>Pharyngeal Neoplasms - radiotherapy</subject><subject>Pharyngeal Neoplasms - surgery</subject><subject>Plastic Surgery</subject><subject>Radiotherapy</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy, Adjuvant</subject><subject>Reconstructive Surgical Procedures</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>1748-6815</issn><issn>1878-0539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFrFTEQxhdRbK3-Ax4kRy_7zCTZ7EZEKEVroeBBPYfsZJbmdd9mTXYL7783y6sePBQGZhK-74P5TVW9Bb4DDvrDftfv57wTHMSuFAfzrDqHru1q3kjzvMyt6mrdQXNWvcp5z7mSoJqX1ZmQshFdp84rf3OYHS4sDmxOFGdKbgkPxJLzIS535TkfWZzYHTnP3OTZRHjPhkTEhtHNLBHGKS9pxSXE6SO7LD9zTMvmUcIwdJny6-rF4MZMbx77RfXr65efV9_q2-_XN1eXtzUqgKUeRD8oLTUaIK9922OjVa-F4qR7QOx922gD6FrTdEr3SreD1gZb4ohKCXlRvT_lzin-Xikv9hAy0ji6ieKaLUgw0KnWyCIVJymmmHOiwc4pHFw6WuB2o2v3dqNrN7q2VKFbTO8e89f-QP6f5S_OIvh0ElDZ8iFQshkDTUg-FFCL9TE8nf_5PzuOYQroxns6Ut7HNU2FnwWbi8H-2O67nRcE5600jfwDRt-gDw</recordid><startdate>20130401</startdate><enddate>20130401</enddate><creator>Benatar, M.J</creator><creator>Dassonville, O</creator><creator>Chamorey, E</creator><creator>Poissonnet, G</creator><creator>Ettaiche, M</creator><creator>Pierre, C.S</creator><creator>Benezery, K</creator><creator>Hechema, R</creator><creator>Demard, F</creator><creator>Santini, J</creator><creator>Bozec, A</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130401</creationdate><title>Impact of preoperative radiotherapy on head and neck free flap reconstruction: A report on 429 cases</title><author>Benatar, M.J ; Dassonville, O ; Chamorey, E ; Poissonnet, G ; Ettaiche, M ; Pierre, C.S ; Benezery, K ; Hechema, R ; Demard, F ; Santini, J ; Bozec, A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-f2bf4636c91ed6d7bc564b6240e6b1ccbd75691ca795846b467f669c7e0cc4423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Comorbidity</topic><topic>Complications</topic><topic>Enteral Nutrition</topic><topic>Female</topic><topic>Free flap</topic><topic>Free Tissue Flaps</topic><topic>Head and neck cancer</topic><topic>Head and Neck Neoplasms - epidemiology</topic><topic>Head and Neck Neoplasms - radiotherapy</topic><topic>Head and Neck Neoplasms - surgery</topic><topic>Head and neck reconstruction</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mouth Neoplasms - epidemiology</topic><topic>Mouth Neoplasms - surgery</topic><topic>Neoadjuvant Therapy</topic><topic>Pharyngeal Neoplasms - epidemiology</topic><topic>Pharyngeal Neoplasms - radiotherapy</topic><topic>Pharyngeal Neoplasms - surgery</topic><topic>Plastic Surgery</topic><topic>Radiotherapy</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy, Adjuvant</topic><topic>Reconstructive Surgical Procedures</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Benatar, M.J</creatorcontrib><creatorcontrib>Dassonville, O</creatorcontrib><creatorcontrib>Chamorey, E</creatorcontrib><creatorcontrib>Poissonnet, G</creatorcontrib><creatorcontrib>Ettaiche, M</creatorcontrib><creatorcontrib>Pierre, C.S</creatorcontrib><creatorcontrib>Benezery, K</creatorcontrib><creatorcontrib>Hechema, R</creatorcontrib><creatorcontrib>Demard, F</creatorcontrib><creatorcontrib>Santini, J</creatorcontrib><creatorcontrib>Bozec, A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Benatar, M.J</au><au>Dassonville, O</au><au>Chamorey, E</au><au>Poissonnet, G</au><au>Ettaiche, M</au><au>Pierre, C.S</au><au>Benezery, K</au><au>Hechema, R</au><au>Demard, F</au><au>Santini, J</au><au>Bozec, A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of preoperative radiotherapy on head and neck free flap reconstruction: A report on 429 cases</atitle><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle><addtitle>J Plast Reconstr Aesthet Surg</addtitle><date>2013-04-01</date><risdate>2013</risdate><volume>66</volume><issue>4</issue><spage>478</spage><epage>482</epage><pages>478-482</pages><issn>1748-6815</issn><eissn>1878-0539</eissn><abstract>Summary Background The primary objective of this study was to evaluate the impact of preoperative radiotherapy on the outcomes of head and neck microvascular reconstruction. The secondary objective was to assess the specific effects of irradiation doses (IDs) ≥60 Gy on the outcomes of head and neck microvascular reconstruction. Methods All patients who underwent head and neck free-flap reconstruction in our institution between 2000 and 2010 were included in this retrospective study. A total of 429 patients were enrolled including 136 patients previously irradiated on the head and neck. The impact of preoperative radiotherapy on free-flap success, local and general complications, postoperative mortality, time of decannulation, duration of enteral nutrition and length of stay was assessed in univariate and multivariate analyses. Results In multivariate analysis, preoperative radiotherapy (irrespective of ID) was a significant risk factor for fistula formation ( p = 0.003) and wound infection ( p = 0.005). Previous neck irradiation at doses ≥60 Gy was associated with an increased risk of free-flap failure ( p = 0.04), overall local complications ( p = 0.05), haematoma ( p = 0.04) and longer duration of enteral nutrition ( p = 0.006) and hospital stay ( p = 0.004). Conclusions Preoperative radiotherapy, particularly for ID ≥ 60 Gy, is one of the main determinants of the outcomes of head and neck microvascular reconstruction.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>23352884</pmid><doi>10.1016/j.bjps.2012.12.019</doi><tpages>5</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Comorbidity Complications Enteral Nutrition Female Free flap Free Tissue Flaps Head and neck cancer Head and Neck Neoplasms - epidemiology Head and Neck Neoplasms - radiotherapy Head and Neck Neoplasms - surgery Head and neck reconstruction Humans Length of Stay Male Middle Aged Mouth Neoplasms - epidemiology Mouth Neoplasms - surgery Neoadjuvant Therapy Pharyngeal Neoplasms - epidemiology Pharyngeal Neoplasms - radiotherapy Pharyngeal Neoplasms - surgery Plastic Surgery Radiotherapy Radiotherapy Dosage Radiotherapy, Adjuvant Reconstructive Surgical Procedures Treatment Outcome Young Adult |
| title | Impact of preoperative radiotherapy on head and neck free flap reconstruction: A report on 429 cases |
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