Surgical resection of carotid body tumors with versus without preoperative embolization: Retrospective case‐control study

Liu, Jianlin; Li, Yanzi; Yang, Lin; Cai, Hui

doi:10.1002/hed.25387

Cited by 32 publications

(35 citation statements)

References 28 publications

(47 reference statements)

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“…[5][6][7] Although surgical adjuncts such as preoperative embolization have been utilized in CBT resection, their effect on clinical outcomes remains poorly defined. [6][7][8][9][10] The effect of preoperative embolization on surgical outcomes for carotid body tumor resection…”

Section: Introductionmentioning

confidence: 99%

“…8,[11][12][13] The familial etiology of this disease is associated with germline mutations and account for 10% of tumors. 2,9 The hyperplastic etiology is thought to be related to chronic hypoxia due to factors such as chronic lung disease and high altitude. 12,14 High-altitude environments have unique CBT epidemiology with increased overall incidence, increased female predominance, and a decreased proportion of bilaterality.…”

Section: Introductionmentioning

confidence: 99%

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The effect of preoperative embolization on surgical outcomes for carotid body tumor resection

et al. 2021

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Objective: Compare the effects of preoperative embolization for carotid body tumor resection on surgical outcomes to carotid body tumor resections without preoperative embolization. Methods: Single-center retrospective review of all consecutive patients who underwent carotid body tumor resection from 2001 to 2019. Surgical outcomes with emphasis on operative time (estimated blood loss and cranial nerve injury) of patients undergoing carotid body tumor resection following preoperative embolization were compared to those undergoing resection alone using unpaired Student’s t-test and Fisher’s exact test. Results: Forty-six patients (15% male, mean age 50 ± 15 years) underwent resection of 49 carotid body tumors. Patients undergoing preoperative embolization ( n = 20 (40%)) had larger mean tumor size (4.0 ± 0.7 vs 3.2 ± 1 cm, p = 0.006), increased Shamblin II/III tumor classification (18 (90%) vs 22 (76%), p < 0.001), operative time (337 ± 195 vs 199 ± 100 min, p = 0.004), and cranial nerve injuries overall (8 (40%) vs 2 (10%), p = 0.01) compared to patients undergoing resection without preoperative embolization ( n = 29 (60%)). In subgroup analysis of Shamblin II/III classification tumors ( n = 40), preoperative embolization ( n = 18) was associated with increased tumor size (4.1 ± 0.6 vs 3.5 ± 0.9 cm, p = 0.01), operative time (351 ± 191 vs 244 ± 105 min, p = 0.02), and cranial nerve injury overall (8 (44%) vs 2 (9%), p = 0.03) compared to resections alone ( n = 19). In further subgroup analysis of large (⩾ 3 cm) tumors ( n = 37), preoperative embolization ( n = 18) was associated with increased operative time (350 ± 191 vs 198 ± 99 min, p = 0.006) and cranial nerve injury overall (8 (44%) vs 2 (11%), p = 0.03) compared to resections alone ( n = 19). There were no significant differences in estimated blood loss, transfusion requirement, or hematoma formation between any of the embolization and non-embolization subgroups. Conclusion: After controlling for tumor Shamblin classification and size, carotid body tumor resections following preoperative embolization were associated with increased operative time and inferior surgical outcomes compared to those tumors undergoing resection alone. Nonetheless, such results remain susceptible to the confounding effects of individual tumor characteristics often used in the decision to perform preoperative embolization, underscoring the need for prospective studies evaluating the utility of preoperative embolization for carotid body tumors.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effect of preoperative embolization on surgical outcomes for carotid body tumor resection

et al. 2021

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“…In this case series, the results of the treatment of 62 CBTs were presented, out of which the majority were treated with surgery with similar results to those recently reported in other studies 9,10 . Several of them, including five systematic reviews, have evaluated the usefulness of preoperative embolization; however, their results have been contradictory regarding the true benefit of this procedure 7,[11][12][13][14][15] 16 . In another meta-analysis that included fewer patients, a decrease in bleeding was also demonstrated (WMD: -0.52; 95% CI: -0.77 to -0.28), as well as shorter operative time (WMD: -0.46; 95% CI: -0.77 to -0.14), with the use of embolization.…”

Section: Discussionmentioning

confidence: 99%

Resultados en el tratamiento del tumor de cuerpo carotídeo, experiencia de 20 años

Gurrola-Machuca¹,

Miranda-Aguirre²,

Gurrola-Luna³

2021

GAMO

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Objective: To present the results of the treatment of a series of cases of Carotid Body Tumors (CBT). Material and methods: Retrospective study in which the cases of CBT of patients treated for 20 years were analyzed. The frequency of presentation was analyzed according to the Shamblin classification, the type of treatment used, complications, as well as the results obtained. Results: 55 patients with 62 CBT were included. According to the Shamblin category, we found 4 cases (6.5%) type I, 44 cases (71%) type II and 14 cases (22.6%) type III. Surgery was performed in 64.5% of tumors. The median intraoperative bleeding was 350 ml, while operative time was 120 min. There were 3 postoperative complications (7.5%), which included one Horner syndrome, one superior laryngeal nerve lesion and one stroke. In the rest of the patients, treatment was with External Beam Radiation Therapy (EBRT) or surveillance. Conclusions: Surgery is the best treatment option for CBT, especially in Shamblin I and II. Preoperative embolization was not essential for resection of these tumors. EBRT appears to be the best treatment for Shamblin III tumors.

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“…[15][16][17] Nevertheless, other specialists suggest that ECA embolization prior to surgery can reduce intraoperative blood loss volume. [18][19][20] Moreover, a recent metaanalysis enrolling 1326 patients suggested that patients who received preoperative embolization had lower intraoperative blood loss volumes and shorter operation duration. 21 However, an interesting study showed that preoperative CBT embolization (0 to 3 days prior to surgery) was associated with an increased unadjusted blood loss rate compared with the nonembolization group, but without statistical significance.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and outcomes of surgical treatment of carotid bifurcation tumors

Zhang

Shu

et al. 2020

J Int Med Res

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Objective To retrospectively review our experience with the diagnosis and treatment of carotid bifurcation tumors (CBFT). Methods This was a retrospective study of 60 patients with CBFT who underwent surgical and conservative treatment. The patients’ clinicopathological features, imaging examination findings, treatment strategy, and prognosis were analyzed. The surgical grade, blood loss, tumor size, operative time, and postoperative complications were analyzed by Spearman’s correlation. Results Resection was performed in 52 patients with 53 tumors. The mean tumor volume, operative time, estimated blood loss, and follow-up time was 47.62 ± 65.28 cm3, 176.1 ± 86.55 minutes, 231.3 ± 354.0 mL, and 44.42 ± 29.30 months, respectively. Pathological examination showed that the number of carotid body tumors (CBT; paraganglioma), neurilemmoma, mesenchymal tissue tumor, and angioleiomyoma was 42, 8, 1, and 1, respectively. Of the CBT group, the rate of Shamblin Type I, II, and III was 11.9%, 59.5%, and 28.6%, and three cases were malignant CBT with lymph node metastasis. Spearman’s correlation analysis showed that complication grade was significantly related to surgical difficulty grade and operative time. Conclusion CBT is the most frequent lesion in CBFT, and CBT may be treated safely by surgical management. The severity of surgical complications is significantly correlated with surgical difficulty.

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Surgical resection of carotid body tumors with versus without preoperative embolization: Retrospective case‐control study

Cited by 32 publications

References 28 publications

The effect of preoperative embolization on surgical outcomes for carotid body tumor resection

The effect of preoperative embolization on surgical outcomes for carotid body tumor resection

Resultados en el tratamiento del tumor de cuerpo carotídeo, experiencia de 20 años

Diagnosis and outcomes of surgical treatment of carotid bifurcation tumors

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