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Reconstructive outcomes in patients with head and neck sarcoma
Albert H Chao1, Erich M Sturgis, Peirong Yu
1Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
Head & Neck
|June 20, 2012
Summary
Reconstructive surgery for head and neck sarcoma patients using free flaps yields good outcomes. Preoperative radiation may reduce long-term complications compared to postoperative radiation.
Area of Science:
- Oncology
- Plastic Surgery
- Head and Neck Surgery
Background:
- Limited data exist on reconstructive outcomes for head and neck sarcoma patients.
- Head and neck sarcomas require complex surgical management including oncologic resection.
Purpose of the Study:
- To evaluate reconstructive outcomes in head and neck sarcoma patients.
- To compare complication rates based on radiation timing (preoperative vs. postoperative).
Main Methods:
- Retrospective review of 133 patients with head and neck sarcoma.
- Analysis of oncologic resection and microvascular free flap reconstruction outcomes.
- Comparison of perioperative and late recipient site complications.
Main Results:
- Overall perioperative complication rate was 30.1% with a 3.0% flap loss rate.
- Late recipient site complications occurred in 7.5% of patients.
- Postoperative radiation significantly increased late complications (19.0%) compared to preoperative or no radiation (p=.005).
Conclusions:
- Microvascular free flap reconstruction provides good outcomes for head and neck sarcoma.
- Preoperative radiation may be advantageous over postoperative radiation to minimize long-term complications.
- Patient selection is key for optimizing reconstructive success in this population.