Salvage neck dissection for isolated neck recurrences in head and neck tumors: Intra and postoperative complications
Background and Objectives The current evidence regarding complications after salvage neck dissection (ND) for isolated regional recurrences (IRRs) in head and neck cancers is poor. The aim of this study is to evaluate the incidence and differences in complication rates of salvage ND after primary su...
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| Veröffentlicht in: | Journal of surgical oncology 2021-10, Vol.124 (5), p.740-750 |
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| creator | Molteni, Gabriele Comini, Lara Le Pera, Beatrice Bassani, Sara Ghirelli, Michael Martone, Andrea Mattioli, Francesco Nocini, Riccardo Santoro, Roberto Spinelli, Giuseppe Presutti, Livio Marchioni, Daniele Mannelli, Giuditta |
| description | Background and Objectives
The current evidence regarding complications after salvage neck dissection (ND) for isolated regional recurrences (IRRs) in head and neck cancers is poor. The aim of this study is to evaluate the incidence and differences in complication rates of salvage ND after primary surgery, radiotherapy, chemoradiotherapy, or combined treatments.
Methods
This was a multicentric retrospective study on 64 patients who underwent salvage ND for IRR in three Italian institutes between 2008 and May 2020.
Results
Complications were detected in 7 of the 34 patients (20.8%) and surgeons described difficult dissection in 20 patients (58.82%). Accidental vascular ligations or nervous injury during surgery were never detected. None of the variables analyzed were statistically significant in predicting the risk of complications, disease‐free survival, or overall survival.
Conclusions
IRR represents a rare entity among total relapses. The incidence of complications after salvage ND for IRR is higher than after primary surgery but at an acceptable rate in experienced hands. However, an adequate balance between functional and oncological outcomes is mandatory. |
| doi_str_mv | 10.1002/jso.26576 |
| format | Article |
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The current evidence regarding complications after salvage neck dissection (ND) for isolated regional recurrences (IRRs) in head and neck cancers is poor. The aim of this study is to evaluate the incidence and differences in complication rates of salvage ND after primary surgery, radiotherapy, chemoradiotherapy, or combined treatments.
Methods
This was a multicentric retrospective study on 64 patients who underwent salvage ND for IRR in three Italian institutes between 2008 and May 2020.
Results
Complications were detected in 7 of the 34 patients (20.8%) and surgeons described difficult dissection in 20 patients (58.82%). Accidental vascular ligations or nervous injury during surgery were never detected. None of the variables analyzed were statistically significant in predicting the risk of complications, disease‐free survival, or overall survival.
Conclusions
IRR represents a rare entity among total relapses. The incidence of complications after salvage ND for IRR is higher than after primary surgery but at an acceptable rate in experienced hands. However, an adequate balance between functional and oncological outcomes is mandatory.</description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.26576</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc</publisher><subject>Cancer surgery ; Dissection ; Head & neck cancer ; head and neck tumors ; isolated neck recurrence ; Postoperative period ; salvage neck dissection ; salvage surgery ; surgical complications ; Surgical outcomes ; Tumors</subject><ispartof>Journal of surgical oncology, 2021-10, Vol.124 (5), p.740-750</ispartof><rights>2021 Wiley Periodicals LLC</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3656-7054992ffa4ee472a5bf11acf5b4789b0ce3c0d4b500f3f245b4164925876eb43</citedby><cites>FETCH-LOGICAL-c3656-7054992ffa4ee472a5bf11acf5b4789b0ce3c0d4b500f3f245b4164925876eb43</cites><orcidid>0000-0002-3639-1504 ; 0000-0001-7079-3964 ; 0000-0003-0599-8423</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjso.26576$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjso.26576$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids></links><search><creatorcontrib>Molteni, Gabriele</creatorcontrib><creatorcontrib>Comini, Lara</creatorcontrib><creatorcontrib>Le Pera, Beatrice</creatorcontrib><creatorcontrib>Bassani, Sara</creatorcontrib><creatorcontrib>Ghirelli, Michael</creatorcontrib><creatorcontrib>Martone, Andrea</creatorcontrib><creatorcontrib>Mattioli, Francesco</creatorcontrib><creatorcontrib>Nocini, Riccardo</creatorcontrib><creatorcontrib>Santoro, Roberto</creatorcontrib><creatorcontrib>Spinelli, Giuseppe</creatorcontrib><creatorcontrib>Presutti, Livio</creatorcontrib><creatorcontrib>Marchioni, Daniele</creatorcontrib><creatorcontrib>Mannelli, Giuditta</creatorcontrib><title>Salvage neck dissection for isolated neck recurrences in head and neck tumors: Intra and postoperative complications</title><title>Journal of surgical oncology</title><description>Background and Objectives
The current evidence regarding complications after salvage neck dissection (ND) for isolated regional recurrences (IRRs) in head and neck cancers is poor. The aim of this study is to evaluate the incidence and differences in complication rates of salvage ND after primary surgery, radiotherapy, chemoradiotherapy, or combined treatments.
Methods
This was a multicentric retrospective study on 64 patients who underwent salvage ND for IRR in three Italian institutes between 2008 and May 2020.
Results
Complications were detected in 7 of the 34 patients (20.8%) and surgeons described difficult dissection in 20 patients (58.82%). Accidental vascular ligations or nervous injury during surgery were never detected. None of the variables analyzed were statistically significant in predicting the risk of complications, disease‐free survival, or overall survival.
Conclusions
IRR represents a rare entity among total relapses. The incidence of complications after salvage ND for IRR is higher than after primary surgery but at an acceptable rate in experienced hands. However, an adequate balance between functional and oncological outcomes is mandatory.</description><subject>Cancer surgery</subject><subject>Dissection</subject><subject>Head & neck cancer</subject><subject>head and neck tumors</subject><subject>isolated neck recurrence</subject><subject>Postoperative period</subject><subject>salvage neck dissection</subject><subject>salvage surgery</subject><subject>surgical complications</subject><subject>Surgical outcomes</subject><subject>Tumors</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp10MtKxDAUBuAgCo6XhW8QcKOLjqdpLo07Ea8MuFDXJc2caMZOU5NWmbe3WleCq8D5v3MIPyFHOcxzAHa2SmHOpFByi8xy0DLToMttMhszlnGlYZfspbQCAK0ln5H-0TQf5gVpi_aNLn1KaHsfWupCpD6FxvS4nMKIdogRW4uJ-pa-ollS0_6G_bAOMZ3Tu7aP5mfchdSHDqPp_QdSG9Zd4635vp0OyI4zTcLD33efPF9fPV3eZouHm7vLi0VmCylkpkBwrZlzhiNyxYyoXZ4b60TNValrsFhYWPJaALjCMT7Oc8k1E6WSWPNin5xMd7sY3gdMfbX2yWLTmBbDkComeKFAyrIc6fEfugpDbMffjUpBoVgu9KhOJ2VjSCmiq7ro1yZuqhyq7_6rsf_qp__Rnk320ze4-R9W948P08YX9zWIGA</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Molteni, Gabriele</creator><creator>Comini, Lara</creator><creator>Le Pera, Beatrice</creator><creator>Bassani, Sara</creator><creator>Ghirelli, Michael</creator><creator>Martone, Andrea</creator><creator>Mattioli, Francesco</creator><creator>Nocini, Riccardo</creator><creator>Santoro, Roberto</creator><creator>Spinelli, Giuseppe</creator><creator>Presutti, Livio</creator><creator>Marchioni, Daniele</creator><creator>Mannelli, Giuditta</creator><general>Wiley Subscription Services, Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3639-1504</orcidid><orcidid>https://orcid.org/0000-0001-7079-3964</orcidid><orcidid>https://orcid.org/0000-0003-0599-8423</orcidid></search><sort><creationdate>20211001</creationdate><title>Salvage neck dissection for isolated neck recurrences in head and neck tumors: Intra and postoperative complications</title><author>Molteni, Gabriele ; Comini, Lara ; Le Pera, Beatrice ; Bassani, Sara ; Ghirelli, Michael ; Martone, Andrea ; Mattioli, Francesco ; Nocini, Riccardo ; Santoro, Roberto ; Spinelli, Giuseppe ; Presutti, Livio ; Marchioni, Daniele ; Mannelli, Giuditta</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3656-7054992ffa4ee472a5bf11acf5b4789b0ce3c0d4b500f3f245b4164925876eb43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cancer surgery</topic><topic>Dissection</topic><topic>Head & neck cancer</topic><topic>head and neck tumors</topic><topic>isolated neck recurrence</topic><topic>Postoperative period</topic><topic>salvage neck dissection</topic><topic>salvage surgery</topic><topic>surgical complications</topic><topic>Surgical outcomes</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Molteni, Gabriele</creatorcontrib><creatorcontrib>Comini, Lara</creatorcontrib><creatorcontrib>Le Pera, Beatrice</creatorcontrib><creatorcontrib>Bassani, Sara</creatorcontrib><creatorcontrib>Ghirelli, Michael</creatorcontrib><creatorcontrib>Martone, Andrea</creatorcontrib><creatorcontrib>Mattioli, Francesco</creatorcontrib><creatorcontrib>Nocini, Riccardo</creatorcontrib><creatorcontrib>Santoro, Roberto</creatorcontrib><creatorcontrib>Spinelli, Giuseppe</creatorcontrib><creatorcontrib>Presutti, Livio</creatorcontrib><creatorcontrib>Marchioni, Daniele</creatorcontrib><creatorcontrib>Mannelli, Giuditta</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Molteni, Gabriele</au><au>Comini, Lara</au><au>Le Pera, Beatrice</au><au>Bassani, Sara</au><au>Ghirelli, Michael</au><au>Martone, Andrea</au><au>Mattioli, Francesco</au><au>Nocini, Riccardo</au><au>Santoro, Roberto</au><au>Spinelli, Giuseppe</au><au>Presutti, Livio</au><au>Marchioni, Daniele</au><au>Mannelli, Giuditta</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Salvage neck dissection for isolated neck recurrences in head and neck tumors: Intra and postoperative complications</atitle><jtitle>Journal of surgical oncology</jtitle><date>2021-10-01</date><risdate>2021</risdate><volume>124</volume><issue>5</issue><spage>740</spage><epage>750</epage><pages>740-750</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><abstract>Background and Objectives
The current evidence regarding complications after salvage neck dissection (ND) for isolated regional recurrences (IRRs) in head and neck cancers is poor. The aim of this study is to evaluate the incidence and differences in complication rates of salvage ND after primary surgery, radiotherapy, chemoradiotherapy, or combined treatments.
Methods
This was a multicentric retrospective study on 64 patients who underwent salvage ND for IRR in three Italian institutes between 2008 and May 2020.
Results
Complications were detected in 7 of the 34 patients (20.8%) and surgeons described difficult dissection in 20 patients (58.82%). Accidental vascular ligations or nervous injury during surgery were never detected. None of the variables analyzed were statistically significant in predicting the risk of complications, disease‐free survival, or overall survival.
Conclusions
IRR represents a rare entity among total relapses. The incidence of complications after salvage ND for IRR is higher than after primary surgery but at an acceptable rate in experienced hands. However, an adequate balance between functional and oncological outcomes is mandatory.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1002/jso.26576</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-3639-1504</orcidid><orcidid>https://orcid.org/0000-0001-7079-3964</orcidid><orcidid>https://orcid.org/0000-0003-0599-8423</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Cancer surgery Dissection Head & neck cancer head and neck tumors isolated neck recurrence Postoperative period salvage neck dissection salvage surgery surgical complications Surgical outcomes Tumors |
| title | Salvage neck dissection for isolated neck recurrences in head and neck tumors: Intra and postoperative complications |
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