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Increased plate and osteosynthesis related complications associated with postoperative concurrent chemoradiotherapy in oral cancer
Author(s) -
Sharan Rajeev,
Iyer Subramania,
Chatni Shilpa S.,
Samuel Jacob,
Sundaram Karimassery R.,
Cohen Richard F.,
Pavithran Keechilat,
Kuriakose Moni Abraham
Publication year - 2008
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20886
Subject(s) - medicine , osteosynthesis , radiation therapy , surgery , head and neck cancer , chemoradiotherapy , complication , odds ratio , univariate analysis , concomitant , multivariate analysis
Background. Plate osteosynthesis is a widely used technique in head and neck reconstructive surgery. The objective of this study was to determine whether postoperative chemoradiotherapy, which was recently introduced for high‐risk head and neck cancer, affects plate and osteosynthesis related complications. Methods. Fifty‐two consecutive patients, who had undergone plate osteosynthesis for mandibular reconstruction between October 2003 and September 2006, were included in the study. The patients were divided into 3 groups: (1) surgery alone ( n = 19), (2) surgery with postoperative radiotherapy ( n = 14), and (3) surgery with concurrent chemoradiotherapy ( n = 19). Outcome measures included any bone or plate related complications. Results. The plate and osteosynthesis related complications occurred in 10.5% of patients in surgery‐alone group, 28.6% in surgery with postoperative radiation group, and 63.2% in surgery with postoperative concurrent chemoradiotherapy group. The differences in the complication rates among these 3 groups were statistically significant ( p = .003). In univariate analysis, postoperative radiation ( p = .007) and concurrent chemotherapy ( p = .003) were found to be significantly associated with complications. In multivariate analysis, only concurrent chemotherapy was found to be statistically significant ( p = .002) with odds ratio of 7.72. Conclusion. Postoperative concurrent chemoradiotherapy significantly increases plate and osteosynthesis related complications in oral cancer. © 2008 Wiley Periodicals, Inc. Head Neck, 2008