Fecha de la publicación: 05/02/2017
Autor: Leif J J Bäck (1), Katri Aro (1), Laura Tapiovaara (1), Pirkka Vikatmaa (2), Remco de Bree (3), Verónica Fernández-Álvarez (4), Luiz P Kowalski (5), Iain J Nixon (6), Alessandra Rinaldo (7), Juan P Rodrigo (8), K Thomas Robbins (9), Carl E Silver (10), Carl H Snyderman (11), Carlos Suárez (12, 13), Robert P Takes (14), Alfio Ferlito (15)
1Department of Otorhinolaryngology – Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
2Department of Vascular Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
3Department of Head and Neck Surgical Oncology, University Medical Center Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands.
4Department of Vascular Surgery, Hospital Universitario de Cabueñes, Gijón, Spain.
5Department Otorhinolaryngology – Head and Neck Surgery, Centro de Tratamento e Pesquisa, Hospital do Cancer A.C. Camargo, São Paulo, Brazil.
6Department of Surgery and Otolaryngology, Head and Neck Surgery, Edinburgh University, Edinburgh, Scotland.
7University of Udine School of Medicine, Udine, Italy.
8Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, IUOPA, ISPA, CIBERONC, Oviedo, Spain.
9Division of Otolaryngology – Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois.
10Department of Surgery, University of Arizona College of Medicine, Phoenix, Arizona.
11Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
12Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, Oviedo, Spain.
13Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain.
14Department of Otolaryngology – Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
15Coordinator of the International Head and Neck Scientific Group.
Background: Sacrifice and reconstruction of the carotid artery in cases of head and neck carcinoma with invasion of the common or internal carotid artery is debated.
Methods: We conducted a systematic search of electronic databases and provide a review and meta-analysis.
Results: Of the 72 articles identified, 24 met the inclusion criteria resulting in the inclusion of 357 patients. The overall perioperative 30-day mortality was 3.6% (13/357). Permanent cerebrovascular complications occurred in 3.6% (13/357). Carotid blowout episodes were encountered in 1.4% (5/357). The meta-regression analysis showed a significant difference in 1-year overall survival between reports published from 1981-1999 (37.0%) and 2001-2016 (65.4%; P = .02).
Conclusion: This review provides evidence that sacrifice with extracranial reconstruction of common or internal carotid artery in selected patients with head and neck carcinoma may improve survival with acceptable complication rates. However, all of the published literature is retrospective involving selected series and, therefore, precludes determining the absolute effectiveness of the surgery.
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