Surgical wound complications after intensive chemoradiotherapy for advanced squamous cell carcinoma of the head and neck

Objective: To define the rate of complications from surgery following intensive chemoradiotherapy in patients with advanced squamous cell carcinoma of the head and neck. Design: The medical records of 131 consecutive patients treated with a combination of chemotherapy and radiation therapy for head and neck squamous cell carcinoma from 1995 through 2002 were reviewed. Thirty-eight patients underwent 50 surgical procedures. Thirty-seven neck dissections were performed either for persistent disease, initial neck stage N2 or greater, recurrent disease, or electively as part of salvage surgery for the primary site. Thirteen salvage operations were performed for persistent or recurrent disease at the primary site. Setting: Academic tertiary care referral center. Patients: A total of 131 consecutive patients treated with a combination of chemotherapy and radiation therapy for head and neck squamous cell carcinoma (mean age at diagnosis, 53 years). Main Outcome Measure: Rate of complications from surgery. Results: Wound complications occurred in 4 (11%) of 38 patients and 5 (10%) of 50 procedures. Major wound complications occurred in 3 (8%) of 38 patients. Minor wound complications occurred in 2 patients (5%). Conclusion: Surgery can be safely performed after intensive chemoradiotherapy.