Late Surgical Outcomes of Carotid Resection and Saphenous Vein Graft Revascularization in Patients with Advanced Head and Neck Squamous Cell Carcinoma

Resection of recurrent neck cancer with carotid artery replacement

“…However, in addition to the technical difficulties of resection, this method necessitates arterial reconstruction. [1][2][3][4][5][6] When invasion of the carotid artery is associated with a recurrent neck cancer, the surgical challenge is even greater, due to scarring of tissues that, in most cases, have been irradiated. Considering the overall poor prognosis for patients with recurrent cervical cancer, doubts have arisen regarding the appropriateness and oncologic value of en bloc resection for primary carcinoma 7 and about the eventual benefits of a risky operation for patients with a predictably low survival rate.…”

Sacrifice and extracranial reconstruction of the common or internal carotid artery in advanced head and neck carcinoma: Review and meta‐analysis

“…The available 2‐year and 5‐year disease‐specific survival rates varied between 40% and 56% and 20% and 49%, respectively. The 2‐year disease‐free survival, which was reported in only 3 articles, varied between 19% and 38% . Only 1 study reported a 5‐year disease‐free survival rate of 13% .…”

“…The quality of the methodology of the reports had a median score of 6 (range 4‐10; maximum 10; Table ). The indication for the extracranial reconstruction in 17 studies was head and neck carcinoma involving the common or internal carotid artery . Seven studies included patients with carotid body tumors and patients treated with carotid ligation, carotid‐sparing surgery, or intracranial reconstruction (Table ) .…”

“…The 2‐year disease‐free survival, which was reported in only 3 articles, varied between 19% and 38% . Only 1 study reported a 5‐year disease‐free survival rate of 13% . Only a few reports compared their survival outcomes between primary treatments and adjuvant (chemo)radiotherapy with no statistical differences encountered.…”

“…They found that arterial grafts were resistant to infection and resulted in superior patency rates, although they reported a high rate of wound complications (43%) and the exposure of the superficial femoral artery graft and the suture line in 3 patients. On the other hand, Biller et al and Nishinari et al revealed satisfactory results with saphenous vein, without graft exposure and good patency rates. Donor site morbidity was not addressed in any of the selected reports.…”