Sacrifice and extracranial reconstruction of the common or internal carotid artery in advanced head and neck carcinoma: Review and meta-analysis

Leif J J Bäck, Katri Aro, Laura Tapiovaara, Pirkka Vikatmaa, Remco de Bree, Verónica Fernández-Álvarez, Luiz P Kowalski, Iain J Nixon, Alessandra Rinaldo, Juan P Rodrigo, K Thomas Robbins, Carl E Silver, Carl H Snyderman, Carlos Suárez, Robert P Takes, Alfio Ferlito

Research output: Contribution to journalReview articlepeer-review


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.

Original languageEnglish
Pages (from-to)1305-1320
Number of pages16
JournalHead & neck
Issue number6
Early online date5 Feb 2018
Publication statusPublished - Jun 2018


  • Journal Article
  • complications
  • head and neck cancer
  • survival
  • reconstruction
  • carotid artery
  • Carotid Artery, Common/pathology
  • Head and Neck Neoplasms/mortality
  • Prognosis
  • Risk Assessment
  • Humans
  • Middle Aged
  • Male
  • Reconstructive Surgical Procedures/methods
  • Carotid Artery, Internal/pathology
  • Disease-Free Survival
  • Neoplasm Invasiveness/pathology
  • Neoplasm Metastasis
  • Survival Analysis
  • Aged, 80 and over
  • Female
  • Aged
  • Neoplasm Staging


Dive into the research topics of 'Sacrifice and extracranial reconstruction of the common or internal carotid artery in advanced head and neck carcinoma: Review and meta-analysis'. Together they form a unique fingerprint.

Cite this