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European Archives of Oto-Rhino-Laryngology

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01-01-2012 | Head and Neck

Complications of total laryngectomy in the era of chemoradiation

Authors: Jan Klozar, Zdenek Cada, Eva Koslabova

Published in: European Archives of Oto-Rhino-Laryngology | Issue 1/2012

Abstract

As more total laryngectomies (TLE) are nowadays performed as salvage procedures, the rate of postoperative complications increases. The primary aim was to report the rates of postoperative local complications for total laryngectomy in patients with previous radiotherapy or chemoradiotherapy (RT/CRT) in comparison with primary TLE data. We attempted to identify patient- and tumor-related factors predictive of postoperative pharyngocutaneous fistula (PCF) formation. The secondary aims were to analyze the survival rate in relation to postoperative complications and to study prognostic factors of survival in TLE patients. A retrospective study was conducted in 208 patients. Logistic regression was used to determine the most significant risk factors for fistula formation. Survival was analyzed by the Kaplan–Meier method, log-rank test, and Cox multivariate regression. PCF developed in 20.7% of cases. In the group of patients with previous RT/CRT, the fistula rate was significantly higher (34%). In multivariate analysis, significant risk factors for fistula formation were previous radiotherapy or chemoradiotherapy (p = 0.02), higher N classification (p = 0.03), and procedure performed by a less experienced surgeon (p = 0.003). The survival and recurrence rates were not influenced by PCF formation. The overall survival rates were lower in patients with previous RT/CRT and in patients with lymph node involvement.

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Title: Complications of total laryngectomy in the era of chemoradiation
Authors: Jan Klozar
Zdenek Cada
Eva Koslabova
Publication date: 01-01-2012
Publisher: Springer-Verlag
Published in: European Archives of Oto-Rhino-Laryngology / Issue 1/2012
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-011-1598-7

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Complications of total laryngectomy in the era of chemoradiation

Abstract

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Abstract

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