Ashley C Mays1, Bharat Yarlagadda2, Virginie Achim3, Ryan Jackson4, Patrik Pipkorn4, Andrew T Huang5, Karthik Rajasekaran6, Shaum Sridharan7, Andrew J Rosko8, Ryan K Orosco9, Andrew M Coughlin10, Mark K Wax11, Yelizaveta Shnayder12, William C Spanos13, Donald Gregory Farwell14, Lee S McDaniel15, Matthew M Hanasono16. 1. Department of Otolaryngology, Louisiana State University, Baton Rouge, Louisiana, USA. 2. Department of Otolaryngology, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA. 3. Department of Otolaryngology, University of Illinois at Chicago, Chicago, Illinois, USA. 4. Department of Otolaryngology, Washington University - St Louis, St Louis, Missouri, USA. 5. Department of Otolaryngology, Baylor College of Medicine, Houston, Texas, USA. 6. Department of Otolaryngology, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 7. Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. 8. Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA. 9. Department of Otolaryngology, University of California San Diego, San Diego, California, USA. 10. Department of Otolaryngology, Nebraska Methodist Health System, Omaha, Nebraska, USA. 11. Department of Otolaryngology, Oregon Health Sciences University, Portland, Oregon, USA. 12. Department of Otolaryngology, University of Kansas, Lawrence, Kansas, USA. 13. Department of Otolaryngology, Sanford Health, Sioux Falls, South Dakota, USA. 14. Department of Otolaryngology, University of California Davis, Sacramento, California, USA. 15. Louisiana State University Health Sciences Center School of Public Health, New Orleans, Louisiana, USA. 16. Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Abstract
BACKGROUND: Immunotherapy agents are used to treat advanced head and neck lesions. We aim to elucidate relationship between immunotherapy and surgical wound complications. METHODS: Retrospective multi-institutional case series evaluating patients undergoing ablative and flap reconstructive surgery and immunotherapy treatment. MAIN OUTCOME: wound complications. RESULTS: Eight-two (62%) patients received preoperative therapy, 89 (67%) postoperative, and 33 (25%) in both settings. Forty-one (31%) patients had recipient site complications, 12 (9%) had donor site. Nineteen (14%) had major recipient site complications, 22 (17%) had minor. There was no statistically significant difference in complications based on patient or tumor-specific variables. Preoperative therapy alone demonstrated increased major complications (odds ratio [OR] 3.7, p = 0.04), and trend to more donor site complications (OR 7.4, p = 0.06), however treatment in both preoperative and postoperative therapy was not. CONCLUSIONS: Preoperative immunotherapy may be associated with increased wound complications. Controlled studies are necessary to delineate this association and potential risks of therapy.
BACKGROUND: Immunotherapy agents are used to treat advanced head and neck lesions. We aim to elucidate relationship between immunotherapy and surgical wound complications. METHODS: Retrospective multi-institutional case series evaluating patients undergoing ablative and flap reconstructive surgery and immunotherapy treatment. MAIN OUTCOME: wound complications. RESULTS: Eight-two (62%) patients received preoperative therapy, 89 (67%) postoperative, and 33 (25%) in both settings. Forty-one (31%) patients had recipient site complications, 12 (9%) had donor site. Nineteen (14%) had major recipient site complications, 22 (17%) had minor. There was no statistically significant difference in complications based on patient or tumor-specific variables. Preoperative therapy alone demonstrated increased major complications (odds ratio [OR] 3.7, p = 0.04), and trend to more donor site complications (OR 7.4, p = 0.06), however treatment in both preoperative and postoperative therapy was not. CONCLUSIONS: Preoperative immunotherapy may be associated with increased wound complications. Controlled studies are necessary to delineate this association and potential risks of therapy.
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