Publication

Predictive factors for pharyngocutaneous fistulization after total laryngectomy: A Dutch Head and Neck Society audit

Dutch Head Neck Soc, Mar-2018, In : European Archives of Oto-Rhino-Laryngology. 275, 3, p. 783-794 12 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Dutch Head Neck Soc (2018). Predictive factors for pharyngocutaneous fistulization after total laryngectomy: A Dutch Head and Neck Society audit. European Archives of Oto-Rhino-Laryngology, 275(3), 783-794. https://doi.org/10.1007/s00405-017-4861-8

Author

Dutch Head Neck Soc. / Predictive factors for pharyngocutaneous fistulization after total laryngectomy : A Dutch Head and Neck Society audit. In: European Archives of Oto-Rhino-Laryngology. 2018 ; Vol. 275, No. 3. pp. 783-794.

Harvard

Dutch Head Neck Soc 2018, 'Predictive factors for pharyngocutaneous fistulization after total laryngectomy: A Dutch Head and Neck Society audit', European Archives of Oto-Rhino-Laryngology, vol. 275, no. 3, pp. 783-794. https://doi.org/10.1007/s00405-017-4861-8

Standard

Predictive factors for pharyngocutaneous fistulization after total laryngectomy : A Dutch Head and Neck Society audit. / Dutch Head Neck Soc.

In: European Archives of Oto-Rhino-Laryngology, Vol. 275, No. 3, 03.2018, p. 783-794.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Dutch Head Neck Soc. Predictive factors for pharyngocutaneous fistulization after total laryngectomy: A Dutch Head and Neck Society audit. European Archives of Oto-Rhino-Laryngology. 2018 Mar;275(3):783-794. https://doi.org/10.1007/s00405-017-4861-8


BibTeX

@article{f2f7f6dfcb88432f83b227461ee8d650,
title = "Predictive factors for pharyngocutaneous fistulization after total laryngectomy: A Dutch Head and Neck Society audit",
abstract = "Incidences of pharyngocutaneous fistulization (PCF) after total laryngectomy (TL) reported in the literature vary widely, ranging from 2.6 to 65.5{\%}. Comparison between different centers might identify risk factors, but also might enable improvements in quality of care. To enable this on a national level, an audit in the 8 principle Dutch Head and Neck Centers (DHNC) was initiated.A retrospective chart review of all 324 patients undergoing laryngectomy in a 2-year (2012 and 2013) period was performed. Overall PCF{\%}, PCF{\%} per center and factors predictive for PCF were identified. Furthermore, a prognostic model predicting the PCF{\%} per center was developed. To provide additional data, a survey among the head and neck surgeons of the participating centers was carried out.Overall PCF{\%} was 25.9. The multivariable prediction model revealed that previous treatment with (chemo)radiotherapy in combination with a long interval between primary treatment and TL, previous tracheotomy, near total pharyngectomy, neck dissection, and BMI <18 were the best predictors for PCF. Early oral intake did not influence PCF rate. PCF{\%} varied quite widely between centers, but for a large extend this could be explained with the prediction model. PCF performance rate (difference between the PCF{\%} and the predicted PCF{\%}) per DHNC, though, shows that not all differences are explained by factors established in the prediction model. However, these factors explain enough of the differences that, compensating for these factors, hospital is no longer independently predictive for PCF.This nationwide audit has provided valid comparative PCF data confirming the known risk factors from the literature which are important for counseling on PCF risks. Data show that variations in PCF{\%} in the DHNCs (in part) are explainable by the variations in these predictive factors. Since elective neck dissection is a major risk factor for PCF, it only should be performed on well funded indication.",
keywords = "Total laryngectomy, Pharyngocutaneous fistulization, National audit, Predictive factors, Predicted pharyngocutaneous fistulization percentages, RISK-FACTORS, FISTULA, COMPLICATIONS, METAANALYSIS, SURGERY, CANCER, RADIOTHERAPY, COMORBIDITY, MANAGEMENT, CARCINOMA",
author = "{Dutch Head Neck Soc} and Liset Lansaat and {van der Noort}, Vincent and Bernard, {Simone E.} and Eerenstein, {Simone E. J.} and Plaat, {Boudewijn E. C.} and Langeveld, {Ton A. P. M.} and Martin Lacko and Hilgers, {Frans J. M.} and {de Bree}, Remco and Takes, {Robert P.} and {van den Brekel}, {Michiel W. M.}",
year = "2018",
month = "3",
doi = "10.1007/s00405-017-4861-8",
language = "English",
volume = "275",
pages = "783--794",
journal = "European Archives of Oto-Rhino-Laryngology",
issn = "0937-4477",
publisher = "SPRINGER",
number = "3",

}

RIS

TY - JOUR

T1 - Predictive factors for pharyngocutaneous fistulization after total laryngectomy

T2 - A Dutch Head and Neck Society audit

AU - Dutch Head Neck Soc

AU - Lansaat, Liset

AU - van der Noort, Vincent

AU - Bernard, Simone E.

AU - Eerenstein, Simone E. J.

AU - Plaat, Boudewijn E. C.

AU - Langeveld, Ton A. P. M.

AU - Lacko, Martin

AU - Hilgers, Frans J. M.

AU - de Bree, Remco

AU - Takes, Robert P.

AU - van den Brekel, Michiel W. M.

PY - 2018/3

Y1 - 2018/3

N2 - Incidences of pharyngocutaneous fistulization (PCF) after total laryngectomy (TL) reported in the literature vary widely, ranging from 2.6 to 65.5%. Comparison between different centers might identify risk factors, but also might enable improvements in quality of care. To enable this on a national level, an audit in the 8 principle Dutch Head and Neck Centers (DHNC) was initiated.A retrospective chart review of all 324 patients undergoing laryngectomy in a 2-year (2012 and 2013) period was performed. Overall PCF%, PCF% per center and factors predictive for PCF were identified. Furthermore, a prognostic model predicting the PCF% per center was developed. To provide additional data, a survey among the head and neck surgeons of the participating centers was carried out.Overall PCF% was 25.9. The multivariable prediction model revealed that previous treatment with (chemo)radiotherapy in combination with a long interval between primary treatment and TL, previous tracheotomy, near total pharyngectomy, neck dissection, and BMI <18 were the best predictors for PCF. Early oral intake did not influence PCF rate. PCF% varied quite widely between centers, but for a large extend this could be explained with the prediction model. PCF performance rate (difference between the PCF% and the predicted PCF%) per DHNC, though, shows that not all differences are explained by factors established in the prediction model. However, these factors explain enough of the differences that, compensating for these factors, hospital is no longer independently predictive for PCF.This nationwide audit has provided valid comparative PCF data confirming the known risk factors from the literature which are important for counseling on PCF risks. Data show that variations in PCF% in the DHNCs (in part) are explainable by the variations in these predictive factors. Since elective neck dissection is a major risk factor for PCF, it only should be performed on well funded indication.

AB - Incidences of pharyngocutaneous fistulization (PCF) after total laryngectomy (TL) reported in the literature vary widely, ranging from 2.6 to 65.5%. Comparison between different centers might identify risk factors, but also might enable improvements in quality of care. To enable this on a national level, an audit in the 8 principle Dutch Head and Neck Centers (DHNC) was initiated.A retrospective chart review of all 324 patients undergoing laryngectomy in a 2-year (2012 and 2013) period was performed. Overall PCF%, PCF% per center and factors predictive for PCF were identified. Furthermore, a prognostic model predicting the PCF% per center was developed. To provide additional data, a survey among the head and neck surgeons of the participating centers was carried out.Overall PCF% was 25.9. The multivariable prediction model revealed that previous treatment with (chemo)radiotherapy in combination with a long interval between primary treatment and TL, previous tracheotomy, near total pharyngectomy, neck dissection, and BMI <18 were the best predictors for PCF. Early oral intake did not influence PCF rate. PCF% varied quite widely between centers, but for a large extend this could be explained with the prediction model. PCF performance rate (difference between the PCF% and the predicted PCF%) per DHNC, though, shows that not all differences are explained by factors established in the prediction model. However, these factors explain enough of the differences that, compensating for these factors, hospital is no longer independently predictive for PCF.This nationwide audit has provided valid comparative PCF data confirming the known risk factors from the literature which are important for counseling on PCF risks. Data show that variations in PCF% in the DHNCs (in part) are explainable by the variations in these predictive factors. Since elective neck dissection is a major risk factor for PCF, it only should be performed on well funded indication.

KW - Total laryngectomy

KW - Pharyngocutaneous fistulization

KW - National audit

KW - Predictive factors

KW - Predicted pharyngocutaneous fistulization percentages

KW - RISK-FACTORS

KW - FISTULA

KW - COMPLICATIONS

KW - METAANALYSIS

KW - SURGERY

KW - CANCER

KW - RADIOTHERAPY

KW - COMORBIDITY

KW - MANAGEMENT

KW - CARCINOMA

U2 - 10.1007/s00405-017-4861-8

DO - 10.1007/s00405-017-4861-8

M3 - Article

VL - 275

SP - 783

EP - 794

JO - European Archives of Oto-Rhino-Laryngology

JF - European Archives of Oto-Rhino-Laryngology

SN - 0937-4477

IS - 3

ER -

ID: 64126352