Leif J J Bäck1, Katri Aro1, Laura Tapiovaara1, Pirkka Vikatmaa2, Remco de Bree3, Verónica Fernández-Álvarez4, Luiz P Kowalski5, Iain J Nixon6, Alessandra Rinaldo7, Juan P Rodrigo8, K Thomas Robbins9, Carl E Silver10, Carl H Snyderman11, Carlos Suárez12,13, Robert P Takes14, Alfio Ferlito15. 1. Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. 2. Department of Vascular Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. 3. Department of Head and Neck Surgical Oncology, University Medical Center Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands. 4. Department of Vascular Surgery, Hospital Universitario de Cabueñes, Gijón, Spain. 5. Department Otorhinolaryngology - Head and Neck Surgery, Centro de Tratamento e Pesquisa, Hospital do Cancer A.C. Camargo, São Paulo, Brazil. 6. Department of Surgery and Otolaryngology, Head and Neck Surgery, Edinburgh University, Edinburgh, Scotland. 7. University of Udine School of Medicine, Udine, Italy. 8. Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, IUOPA, ISPA, CIBERONC, Oviedo, Spain. 9. Division of Otolaryngology - Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois. 10. Department of Surgery, University of Arizona College of Medicine, Phoenix, Arizona. 11. Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. 12. Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, Oviedo, Spain. 13. Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain. 14. Department of Otolaryngology - Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. 15. Coordinator of the International Head and Neck Scientific Group.
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.
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.