CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2015; 36(04): 249-254
DOI: 10.4103/0971-5851.171548
ORIGINAL ARTICLE

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

Poonam Joshi
Department of Head and Neck Surgery, Tata Memorial Hospital, Mumbai, Maharashtra, India
,
Amit Joshi
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
,
Kumar Prabhash
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
,
Vanita Noronha
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
,
Pankaj Chaturvedi
Department of Head and Neck Surgery, Tata Memorial Hospital, Mumbai, Maharashtra, India
› Author Affiliations
Financial support and sponsorship Nil.

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.



Publication History

Publication Date:
12 July 2021 (online)

© 2015. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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  • References

  • 1 Agarwal AK, Sethi A, Sareen D, Dhingra S. Treatment delay in oral and oropharyngeal cancer in our population: The role of socio-economic factors and health-seeking behaviour. Indian J Otolaryngol Head Neck Surg 2011;63:145-50.
  • 2 Patel UA, Lynn-Macrae A, Rosen F, Holloway N, Kern R. Advanced stage of head and neck cancer at a tertiary-care county hospital. Laryngoscope 2006;116:1473-7.
  • 3 Otto S. Oncology Nursing. 4 th ed. London: Mosby; 2001.
  • 4 Patil VM, Noronha V, Joshi A, Muddu VK, Gulia S, Bhosale B, et al. Induction chemotherapy in technically unresectable locally advanced oral cavity cancers: Does it make a difference? Indian J Cancer 2013;50:1-8.
  • 5 Vermorken JB, Remenar E, van Herpen C, Gorlia T, Mesia R, Degardin M, et al. Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer. N Engl J Med 2007;357:1695-704.
  • 6 Licitra L, Grandi C, Guzzo M, Mariani L, Lo Vullo S, Valvo F, et al. Primary chemotherapy in resectable oral cavity squamous cell cancer: A randomized controlled trial. J Clin Oncol 2003;21:327-33.
  • 7 Ensley JF, Jacobs JR, Weaver A, Kinzie J, Crissman J, Kish JA, et al. Correlation between response to cisplatinum-combination chemotherapy and subsequent radiotherapy in previously untreated patients with advanced squamous cell cancers of the head and neck. Cancer 1984;54:811-4.
  • 8 Paccagnella A, Orlando A, Marchiori C, Zorat PL, Cavaniglia G, Sileni VC, et al. Phase III trial of initial chemotherapy in stage III or IV head and neck cancers: A study by the Gruppo di Studio sui Tumori della Testa e del Collo. J Natl Cancer Inst 1994;86:265-72.
  • 9 Zorat PL, Paccagnella A, Cavaniglia G, Loreggian L, Gava A, Mione CA, et al. Randomized phase III trial of neoadjuvant chemotherapy in head and neck cancer: 10-year follow-up. J Natl Cancer Inst 2004;96:1714-7.
  • 10 Vokes EE, Weichselbaum RR, Mick R, McEvilly JM, Haraf DJ, Panje WR. Favorable long-term survival following induction chemotherapy with cisplatin, fluorouracil, and leucovorin and concomitant chemoradiotherapy for locally advanced head and neck cancer. J Natl Cancer Inst 1992;84:877-82.
  • 11 Cohen EW, Karrison T, Kocherginsky M, Huang CH, Agulnik M, Mittal BB, et al. DeCIDE: A phase III randomized trial of docetaxel (D), cisplatin (P), 5-fluorouracil (F) (TPF) induction chemotherapy (IC) in patients with N2/N3 locally advanced squamous cell carcinoma of the head and neck (SCCHN). Proc Am Soc Clin Oncol 2012;30 (Suppl): abstr 5500.
  • 12 Mendelsohn FA, Divino CM, Reis ED, Kerstein MD. Wound care after radiation therapy. Adv Skin Wound Care 2002;15:216-24.
  • 13 Joseph DL, Shumrick DL. Risks of head and neck surgery in previously irradiated patients. Arch Otolaryngol 1973;97: 381-4.
  • 14 Kumagai K, Rouvelas I, Tsai JA, Mariosa D, Klevebro F, Lindblad M, et al. Meta-analysis of postoperative morbidity and perioperative mortality in patients receiving neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal and gastro-oesophageal junctional cancers. Br J Surg 2014;101:321-38.
  • 15 Liao Y, Yang ZL, Peng JS, Xiang J, Wang JP. Neoadjuvant chemotherapy for gastric cancer: A meta-analysis of randomized, controlled trials. J Gastroenterol Hepatol 2013; 28:777-82.
  • 16 Li ZY, Shan F, Zhang LH, Bu ZD, Wu AW, Wu XJ, et al. Complications after radical gastrectomy following FOLFOX7 neoadjuvant chemotherapy for gastric cancer. World J Surg Oncol 2011;9:110.
  • 17 Grossman HB, Natale RB, Tangen CM, Speights VO, Vogelzang NJ, Trump DL, et al. Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med 2003;349:859-66.
  • 18 Brouchet L, Bauvin E, Marcheix B, Bigay-Game L, Renaud C, Berjaud J, et al. Impact of induction treatment on postoperative complications in the treatment of non-small cell lung cancer. J Thorac Oncol 2007;2:626-31.
  • 19 Harari PM, Cleary JF, Hartig GK. Evolving patterns of practice regarding the use of chemoradiation for advanced head and neck cancer patients. Proc Am Soc Clin Oncol 2001;20:226a. [226a (Abstr 903)].
  • 20 Shamberger RC, Devereux DF, Brennan MF. The effect of chemotherapeutic agents on wound healing. Int Adv Surg Oncol 1981;4:15-58.
  • 21 Al-Gwaiz LA, Babay HH. The diagnostic value of absolute neutrophil count, band count and morphologic changes of neutrophils in predicting bacterial infections. Med Princ Pract 2007;16:344-7.
  • 22 Engelmann U, Grimm K, Grönniger J, Bürger R, Jacobi GH. Influence of cis-platinum on healing of enterostomies in the rat. Eur Urol 1983;9:45-9.
  • 23 Staley CJ, Trippel OH, Preston FW. Influence of 5-fluorouracil on wound healing. Surgery 1961;49:450-3.
  • 24 Meric F, Milas M, Hunt KK, Hess KR, Pisters PW, Hildebrandt G, et al. Impact of neoadjuvant chemotherapy on postoperative morbidity in soft tissue sarcomas. J Clin Oncol 2000;18:3378-83.
  • 25 Kolb BA, Buller RE, Connor JP, DiSaia PJ, Berman ML. Effects of early postoperative chemotherapy on wound healing. Obstet Gynecol 1992;79:988-92.
  • 26 Winquist E, Kirchner TS, Segal R, Chin J, Lukka H; Genitourinary Cancer Disease Site Group, Cancer Care Ontario Program in Evidence-based Care Practice Guidelines Initiative. Neoadjuvant chemotherapy for transitional cell carcinoma of the bladder: A systematic review and meta-analysis. J Urol 2004;171(2 Pt 1):561-9.
  • 27 Sláma J, Cibula D, Freitag P, Fischerová D, Janousek M, Pavlista D, et al. Contribution of neoadjuvant chemotherapy for operability of cancers of the uterine cervix. Ceska Gynekol 2007;72:116-9.
  • 28 Hou JY, Kelly MG, Yu H, McAlpine JN, Azodi M, Rutherford TJ, et al. Neoadjuvant chemotherapy lessens surgical morbidity in advanced ovarian cancer and leads to improved survival in stage IV disease. Gynecol Oncol 2007;105:211-7.