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

doi:10.1002/hed.25093

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 journal › Review article › peer-review

Abstract

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 language	English
Pages (from-to)	1305-1320
Number of pages	16
Journal	Head & neck
Volume	40
Issue number	6
Early online date	5 Feb 2018
DOIs	https://doi.org/10.1002/hed.25093
Publication status	Published - Jun 2018

Keywords

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

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Bäck, L. J. J., Aro, K., Tapiovaara, L., Vikatmaa, P., de Bree, R., Fernández-Álvarez, V., Kowalski, L. P., Nixon, I. J., Rinaldo, A., Rodrigo, J. P., Robbins, K. T., Silver, C. E., Snyderman, C. H., Suárez, C., Takes, R. P., & Ferlito, A. (2018). Sacrifice and extracranial reconstruction of the common or internal carotid artery in advanced head and neck carcinoma: Review and meta-analysis. Head & neck, 40(6), 1305-1320. https://doi.org/10.1002/hed.25093

@article{c80272f5e0e2440db93de9e75241d855,

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

abstract = "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.",

keywords = "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",

author = "B{\"a}ck, {Leif J J} and Katri Aro and Laura Tapiovaara and Pirkka Vikatmaa and {de Bree}, Remco and Ver{\'o}nica Fern{\'a}ndez-{\'A}lvarez and Kowalski, {Luiz P} and Nixon, {Iain J} and Alessandra Rinaldo and Rodrigo, {Juan P} and Robbins, {K Thomas} and Silver, {Carl E} and Snyderman, {Carl H} and Carlos Su{\'a}rez and Takes, {Robert P} and Alfio Ferlito",

note = "Funding Information: The authors thank Tuija Poussa, MSc, biostatistician (www.stat.counsulting.fi), for support and assistance in statistical analysis and reporting the results. Publisher Copyright: {\textcopyright} 2018 Wiley Periodicals, Inc. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.",

year = "2018",

month = jun,

doi = "10.1002/hed.25093",

language = "English",

volume = "40",

pages = "1305--1320",

journal = "Head & neck",

issn = "1043-3074",

publisher = "John Wiley & Sons Inc.",

number = "6",

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Bäck, LJJ, Aro, K, Tapiovaara, L, Vikatmaa, P, de Bree, R, Fernández-Álvarez, V, Kowalski, LP, Nixon, IJ, Rinaldo, A, Rodrigo, JP, Robbins, KT, Silver, CE, Snyderman, CH, Suárez, C, Takes, RP & Ferlito, A 2018, 'Sacrifice and extracranial reconstruction of the common or internal carotid artery in advanced head and neck carcinoma: Review and meta-analysis', Head & neck, vol. 40, no. 6, pp. 1305-1320. https://doi.org/10.1002/hed.25093

TY - JOUR

T1 - Sacrifice and extracranial reconstruction of the common or internal carotid artery in advanced head and neck carcinoma

T2 - Review and meta-analysis

AU - Bäck, Leif J J

AU - Aro, Katri

AU - Tapiovaara, Laura

AU - Vikatmaa, Pirkka

AU - de Bree, Remco

AU - Fernández-Álvarez, Verónica

AU - Kowalski, Luiz P

AU - Nixon, Iain J

AU - Rinaldo, Alessandra

AU - Rodrigo, Juan P

AU - Robbins, K Thomas

AU - Silver, Carl E

AU - Snyderman, Carl H

AU - Suárez, Carlos

AU - Takes, Robert P

AU - Ferlito, Alfio

N1 - Funding Information: The authors thank Tuija Poussa, MSc, biostatistician (www.stat.counsulting.fi), for support and assistance in statistical analysis and reporting the results. Publisher Copyright: © 2018 Wiley Periodicals, Inc. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.

PY - 2018/6

Y1 - 2018/6

N2 - 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.

AB - 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.

KW - Journal Article

KW - complications

KW - head and neck cancer

KW - survival

KW - reconstruction

KW - carotid artery

KW - Carotid Artery, Common/pathology

KW - Head and Neck Neoplasms/mortality

KW - Prognosis

KW - Risk Assessment

KW - Humans

KW - Middle Aged

KW - Male

KW - Reconstructive Surgical Procedures/methods

KW - Carotid Artery, Internal/pathology

KW - Disease-Free Survival

KW - Neoplasm Invasiveness/pathology

KW - Neoplasm Metastasis

KW - Survival Analysis

KW - Aged, 80 and over

KW - Female

KW - Aged

KW - Neoplasm Staging

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U2 - 10.1002/hed.25093

DO - 10.1002/hed.25093

M3 - Review article

C2 - 29405536

SN - 1043-3074

VL - 40

SP - 1305

EP - 1320

JO - Head & neck

JF - Head & neck

IS - 6

ER -

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

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