Resection of recurrent neck cancer with carotid artery replacement

Abstract

Aggressive en bloc resection of recurrent neck cancer with PTFE grafting can be curative in patients without metastases at the time of redo surgery. In this subset of patients, extensive neck surgery with carotid artery replacement can lead to excellent local control of the disease with improved quality of survival.

Autologous Bifurcated Carotid Artery Reconstruction: Technique and 2 Year Follow Up

“…22 All permanent cranial nerve lesions (15%) occurred in patients operated for cervical tumours, in whom the vagus nerve had to be resected and dissection was more extensive than in patients in group 1 or 2 (recurrent carotid artery stenosis and carotid artery aneurysm). These findings are comparable to data reported by Illuminti et al, 7 who reported three vocal cord palsies in 31 patients operated on for recurrent neck cancer.…”

“…8 It is recognised, however, that other groups have used synthetic graft material with excellent outcome in similar indications. 6,7,21 In summary, carotid artery reconstruction using autologous bifurcated carotid interposition grafts with additional reconstruction of the ECA provides comparable mid-term results. This technique does not add significant morbidity, as brain perfusion is restored as fast as in other bypass procedures.…”

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

“…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 follow‐up time of the reports varied from 18 days to 175 months; this time was not reported in 2 articles. In 5 articles, the mean follow‐up time was more than 2 years …”

“…Accordingly, the 1‐year, 2‐year, and 5‐year overall survival rates varied between 23% and 100% (5 missing), 0% and 82% (6 missing), and 0% and 49% (11 missing), respectively. Disease‐specific survival was specifically reported in 2 articles and was not possible to obtain from the other reports . The available 2‐year and 5‐year disease‐specific survival rates varied between 40% and 56% and 20% and 49%, respectively.…”