Comparison of postoperative complications in advanced head and neck cancer patients receiving neoadjuvant chemotherapy followed by surgery versus surgery alone

Abstract

Background:Head and neck cancer is the third most common cancer in India with 60% presenting in advanced stages. There is the emerging role of neoadjuvant chemotherapy (NACT) in the management of these advanced cancers. There is a general perception that complication rates are higher with the use of NACT.Materials and Methods:This is a retrospectively collected data of head and neck cancer patients operated at our hospital from March 2013 to September 2014. A total of 205 patients were included in the study. These patients were studied in two groups. Group 1 included 153 patients who underwent surgery alone, and Group 2 included 52 patients who received 2-3 cycles of NACT followed by surgery.Results:The mean age of the population was 51 years in the Group 1 and 45 years in Group 2. The hospital stay and readmissions in postoperative period were similar in the two groups. In this study, the complication rate was 37.9% in the surgery patients and 30.8% in the NACT patients (P = 0.424).Conclusion:The postoperative complication rates in patients who received NACT followed by surgery were not significantly different from those who underwent surgery.

Prospective Phase II Open-Label Randomized Controlled Trial to Compare Mandibular Preservation in Upfront Surgery With Neoadjuvant Chemotherapy Followed by Surgery in Operable Oral Cavity Cancer

“…Among patients who underwent marginal mandibulectomy, only one patient had bony invasion on final histopathology, which was superficial with adequate bony margin. There was no difference in surgical morbidity between the two arms; similarly, results have been reported by Joshi et al 24 The response rate to NACT seen in our study is lower than that observed in other studies, but it is comparable with the response seen with DCF in our previous studies and studies performed in India. 13,25 The lower response might be a factor of the differential method used for response assessment as per the Protocol, whereby a decrease .…”

“…Among patients who underwent marginal mandibulectomy, only one patient had bony invasion on final histopathology, which was superficial with adequate bony margin. There was no difference in surgical morbidity between the two arms; similarly, results have been reported by Joshi et al 24…”