Article ; Online: Double trouble: A cohort study of re-irradiation and laryngectomy - Severity of and risk for pharyngocutaneous fistula.
2022 Volume 134, Page(s) 106069
Abstract: Objectives: Pharyngocutaneous fistula (PCF) is a devastating complication of laryngectomy. Different factors, principally previous irradiation, increases the risk for PCF formation. The current study objectives is to investigate the potential negative ... ...
Abstract | Objectives: Pharyngocutaneous fistula (PCF) is a devastating complication of laryngectomy. Different factors, principally previous irradiation, increases the risk for PCF formation. The current study objectives is to investigate the potential negative effect of re-irradiation on fistula development. Materilas and methods This is a single, referral, medical center retrospective, cohort study, conducted between the years 2011-2021. Electronic medical files, surgical notes, laboratory records and radiation plan (dose and time interval in case of re-irradiation) were examined. Main outcomes and measures Risk and predictors associated with PCF formation. Risk and severity of PCF in the setting of re-irradiation. Results: Overall, 27 laryngectomized patients were investigated, of whom 21 patients had single radiation (pre or post-operative radiation) and the other 6 patients had two radiation treatments (before and after laryngectomy). The fistula rate was 33.33% (7/21) in the single radiation compared (p = 0.14) to 66.66% (4/6) in the re-irradiation group of patients (including late-onset fistulas). All single radiation PCF were self-limited, whereas, 3 out of 4 fistulas in the re-irradiation group were longstanding or permanent. In the re-irradiation group of patients, a shorter time interval between the first and second radiation treatments was demonstrated among those with fistula formation compared to patients with uneventful laryngectomy (p = 0.08). Conclusion: Re-irradiation and especially a brief interval between the radiation treatments is associated with a severe PCF. |
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MeSH term(s) | Cohort Studies ; Cutaneous Fistula/etiology ; Cutaneous Fistula/surgery ; Humans ; Laryngeal Neoplasms/complications ; Laryngeal Neoplasms/radiotherapy ; Laryngeal Neoplasms/surgery ; Laryngectomy/adverse effects ; Pharyngeal Diseases/etiology ; Pharyngeal Diseases/surgery ; Postoperative Complications/etiology ; Re-Irradiation/adverse effects ; Retrospective Studies |
Language | English |
Publishing date | 2022-08-12 |
Publishing country | England |
Document type | Letter |
ZDB-ID | 1120465-5 |
ISSN | 1879-0593 ; 0964-1955 ; 1368-8375 |
ISSN (online) | 1879-0593 |
ISSN | 0964-1955 ; 1368-8375 |
DOI | 10.1016/j.oraloncology.2022.106069 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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