Comparison of pharyngocutaneous fistula between patients followed by primary laryngopharyngectomy and salvage laryngopharyngectomy for advanced hypopharyngeal cancer Journal Article
| Authors: | Tsou, Y. A.; Hua, C. H.; Lin, M. H.; Tseng, H. C.; Tsai, M. H.; Shaha, A. |
| Article Title: | Comparison of pharyngocutaneous fistula between patients followed by primary laryngopharyngectomy and salvage laryngopharyngectomy for advanced hypopharyngeal cancer |
| Abstract: | Background We analyzed the incidence rate, possible etiology, and management of pharyngocutaneous fistula after laryngopharyngectomy between hypopharyngeal cancer patients who received surgery first and subsequently concurrent chemoradiation therapy (CCRT) and those who received CCRT first followed by surgical salvage. Methods This is a case cohort, retrospective study collected in a tertiary medical center from January 1996 to July 2007. Results From the total of 160 patients, 52 patients (32.5%) developed pharyngocutaneous fistula. There is a significant difference between the pharyngocutaneous fistula rate of those with initial CCRT and the initial surgery groups. By univariate analysis and multiple logistic regression, tests revealed that preoperative radiation and hypo-albuminemia are risk factors for pharyngocutaneous fistula. A prolonged hospital course was noted among patients in the fistula group, especially when they received surgical repair, had hypo-albuminemia (albumin, <2.5 g/dL), or received preoperative radiation therapy (pre-OPRT). Conclusions Preoperative radiation therapy and hypo-albuminemia increase the fistula rate significantly. A prolonged hospital course was noted among all fistula patients. © 2010 Wiley Periodicals, Inc. |
| Keywords: | adult; controlled study; aged; aged, 80 and over; middle aged; treatment failure; retrospective studies; major clinical study; laryngectomy; neck dissection; salvage therapy; cutaneous fistula; fistula; pharyngeal diseases; cisplatin; advanced cancer; multimodality cancer therapy; antineoplastic agents; radiation dose; chemotherapy, adjuvant; neoadjuvant therapy; radiotherapy, adjuvant; cohort studies; cohort analysis; risk factors; retrospective study; time factors; postoperative complication; hypoalbuminemia; length of stay; radiation therapy; multivariate analysis; tertiary health care; ear nose throat surgery; pharyngocutaneous fistula; hypopharynx cancer; hypopharyngeal cancer; hypopharyngeal neoplasms; serum albumin; preoperative radiotherapy; hypo-albuminemia; laryngopharyngectomy; hypopharyngectomy; pharyngectomy |
| Journal Title: | Head & Neck |
| Volume: | 32 |
| Issue: | 11 |
| ISSN: | 1043-3074 |
| Publisher: | John Wiley & Sons, Inc. |
| Date Published: | 2010-11-01 |
| Start Page: | 1494 |
| End Page: | 1500 |
| Language: | English |
| DOI: | 10.1002/hed.21352 |
| PUBMED: | 20187019 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Export Date: 20 April 2011" - "CODEN: HEANE" - "Source: Scopus" |
