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. 2021 May;43(5):1509-1520.
doi: 10.1002/hed.26601. Epub 2021 Jan 8.

Examining the relationship of immunotherapy and wound complications following flap reconstruction in patients with head and neck cancer

Ashley C Mays  1 , Bharat Yarlagadda  2 , Virginie Achim  3 , Ryan Jackson  4 , Patrik Pipkorn  4 , Andrew T Huang  5 , Karthik Rajasekaran  6 , Shaum Sridharan  7 , Andrew J Rosko  8 , Ryan K Orosco  9 , Andrew M Coughlin  10 , Mark K Wax  11 , Yelizaveta Shnayder  12 , William C Spanos  13 , Donald Gregory Farwell  14 , Lee S McDaniel  15 , Matthew M Hanasono  16 ; American Head and Neck Society Reconstructive Microsurgery Committee
Affiliations

Examining the relationship of immunotherapy and wound complications following flap reconstruction in patients with head and neck cancer

Ashley C Mays et al. Head Neck. 2021 May.

Abstract

Background: Immunotherapy agents are used to treat advanced head and neck lesions. We aim to elucidate relationship between immunotherapy and surgical wound complications.

Methods: Retrospective multi-institutional case series evaluating patients undergoing ablative and flap reconstructive surgery and immunotherapy treatment.

Main outcome: wound complications.

Results: Eight-two (62%) patients received preoperative therapy, 89 (67%) postoperative, and 33 (25%) in both settings. Forty-one (31%) patients had recipient site complications, 12 (9%) had donor site. Nineteen (14%) had major recipient site complications, 22 (17%) had minor. There was no statistically significant difference in complications based on patient or tumor-specific variables. Preoperative therapy alone demonstrated increased major complications (odds ratio [OR] 3.7, p = 0.04), and trend to more donor site complications (OR 7.4, p = 0.06), however treatment in both preoperative and postoperative therapy was not.

Conclusions: Preoperative immunotherapy may be associated with increased wound complications. Controlled studies are necessary to delineate this association and potential risks of therapy.

Keywords: free flap reconstruction; head and neck cancer; immunotherapy; wound complications.

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