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Increased plate and osteosynthesis related complications associated with postoperative concurrent chemoradiotherapy
Rajeev Sharan1, Subramania Iyer, Shilpa S Chatni
1Head and Neck Institute, Amrita Institute of Medical Sciences and Research Centre, Amrita Lane, Elamakkara PO, Kochi, Kerala, India.
Background:
Plate osteosynthesis is a widely used technique in head and neck reconstructive surgery. The objective of this study was to determine whether postoperative chemoradiotherapy, which was recently introduced for high-risk head and neck cancer, affects plate and osteosynthesis related complications.
Methods:
Fifty-two consecutive patients, who had undergone plate osteosynthesis for mandibular reconstruction between October 2003 and September 2006, were included in the study. The patients were divided into 3 groups: (1) surgery alone (n = 19), (2) surgery with postoperative radiotherapy (n = 14), and (3) surgery with concurrent chemoradiotherapy (n = 19). Outcome measures included any bone or plate related complications.
Results:
The plate and osteosynthesis related complications occurred in 10.5% of patients in surgery-alone group, 28.6% in surgery with postoperative radiation group, and 63.2% in surgery with postoperative concurrent chemoradiotherapy group. The differences in the complication rates among these 3 groups were statistically significant (p = .003). In univariate analysis, postoperative radiation (p = .007) and concurrent chemotherapy (p = .003) were found to be significantly associated with complications. In multivariate analysis, only concurrent chemotherapy was found to be statistically significant (p = .002) with odds ratio of 7.72.
Conclusion:
Postoperative concurrent chemoradiotherapy significantly increases plate and osteosynthesis related complications in oral cancer.
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