Elective vs. emergency tracheotomy complications in advanced hypopharyngeal cancer

Vulcu Cordunianu,Alina-Georgiana; Cordunianu,Mihai Alexandru; Cochior,Daniel

doi:10.3892/etm.2024.12677

Elective vs. emergency tracheotomy complications in advanced hypopharyngeal cancer

Authors:
- Alina-Georgiana Vulcu Cordunianu
- Mihai Alexandru Cordunianu
- Daniel Cochior
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Affiliations: Titu Maiorescu Doctoral School of Medicine, Titu Maiorescu University of Bucharest, Bucharest 040317, Romania
Published online on: August 5, 2024 https://doi.org/10.3892/etm.2024.12677
Article Number: 388
Copyright: © Vulcu Cordunianu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Squamous cell carcinoma of the hypopharyngeal region is a rare, aggressive disease with a poor prognosis and a high mortality rate, and represents up to 95% of all hypopharyngeal tumors. Patients with upper aerodigestive tract tumors can develop airway compromise before or during chemoradiotherapy. The present study aims to investigate the complication differences between elective tracheostomy and emergency‑setting tracheostomy for patients with advanced hypopharyngeal squamous cell. The study group included 36 patients and analyzed the number and type of complications, functional outcomes and comparation of the laboratory testing in all the patients at 3 specific points (before tracheotomy, during the radiation therapy and at least 3 months after completion of radiation therapy). In addition, univariate analysis was performed in order to evaluate the prognosis of local control rates. The type and number of complications between elective and emergency‑setting tracheostomy varied, but all the complications were resolved, and no hypoxic complications secondary to displacement of the tracheostomy tube or death cases related to the tracheostomy occurred. A total of 20/36 patients presented with complications, with 73% (16 patients) from the emergency tracheostomy cohort and 36% (4 patients) from the elective tracheostomy group. More than half of the elective tracheostomy (6/11 patients) responded favorably to the treatment, with a higher frequency than the patients with emergency tracheostomy (5/22 patients). The present study did not encounter significant statistical differences (P>0.05) of the treatment end‑result regarding the type of tracheostomy performed, but the prediction analysis found for the patients aged under 60 years old, elective tracheostomy was associated with a higher chance of favorable treatment end result.

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1	Vila PM and Uppaluri R: Neoplasms of the hypopharynx and cervical esophagus. In: Cummings Otolaryngology Head and Neck Surgery. Flint PW and Cummings CW (eds). 6th edition, Vol II. Pp1537-1553, Elsevier Saunders, Philadelphia, 2015.
2	Lewandowska A, Rudzki G, Lewandowski T, Prochnicki M, Rudzki S, Laskowska B and Brudniak J: Quality of life of cancer patients treated with chemotherapy. Int J Environ Res Public Health. 17(6938)2020.PubMed/NCBI View Article : Google Scholar
3	Behrborn H, Kaschke O, Nawka T and Swift A: Ear, Nose, and throat diseases with head and neck surgery. 3th ed. Stuttgart: Thieme, 2009: pp293-329.
4	Di Credico G, Polesel J, Dal Maso L, Pauli F, Torelli N, Luce D, Radoï L, Matsuo K, Serraino D, Brennan P, et al: Alcohol drinking and head and neck cancer risk: The joint effect of intensity and duration. Br J Cancer. 123:1456–1463. 2020.PubMed/NCBI View Article : Google Scholar
5	Larsson LG, Sandström A and Westling P: Relationship of Plummer-Vinson disease to cancer of the upper alimentary tract in Sweden. Cancer Res. 35:3308–3316. 1975.PubMed/NCBI
6	Anderson SR and Sinacori JT: Plummer-Vinson syndrome heralded by postcricoid carcinoma. Am J Otolaryngol. 28:22–24. 2007.PubMed/NCBI View Article : Google Scholar
7	Ndiaye IC, Diom ES, Diop F, Tall A, Ndiaye M, Essalki I, Déguénonvo R, Diallo BK, Diouf R and Diop EM: Squamous carcinoma of the hypopharynx in children in Sénégal: Between disarray and enigma. Int J Pediatr Otorhinolaryngol. 73:357–361. 2009.PubMed/NCBI View Article : Google Scholar
8	Amar A, Curioni OA, Paiva DL, Rapoport A, Dedivitis RA, Cernea CR and Brandão LG: Epidemiological assessment and therapeutic response in hypopharyngeal cancer. Braz J Otorhinolaryngol. 79:500–504. 2013.PubMed/NCBI View Article : Google Scholar : (In English, Portuguese).
9	Jayalekshmi PA, Nandakumar A, Akiba S, Gangadharan P and Koriyama C: Associations of tobacco use and alcohol drinking with laryngeal and hypopharyngeal cancer risks among men in Karunagappally, Kerala, India -Karunagappally cohort study. PLoS One. 8(e73716)2013.PubMed/NCBI View Article : Google Scholar
10	Dahm V, Haitel A, Kaider A, Stanisz I, Beer A and Lill C: Cancer stage and pack-years, but not p16 or HPV, are relevant for survival in hypopharyngeal and laryngeal squamous cell carcinomas. Eur Arch Otorhinolaryngol. 275:1837–1843. 2018.PubMed/NCBI View Article : Google Scholar
11	Machiels JP, Leemans CR, Golusinski W, Grau C, Licitra L and Gregoire V: EHNS Executive Board, ESMO Guidelines Committee, ESTRO Executive Board. Reprint of ‘Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx: EHNS-ESMO-ESTRO clinical practice guidelines for diagnosis, treatment and follow-up’. Oral Oncol. 113(105042)2021.PubMed/NCBI View Article : Google Scholar
12	Eckel HE and Bradley PJ: Future perspectives in hypopharyngeal cancer care. Adv Otorhinolaryngol. 83:167–175. 2019.PubMed/NCBI View Article : Google Scholar
13	Eckel HE and Bradley PJ: Treatment Options for Hypopharyngeal Cancer. Adv Otorhinolaryngol. 83:47–53. 2019.PubMed/NCBI View Article : Google Scholar
14	Gordin E: Neoadjuvant chemotherapy for hypopharyngeal squamous cell carcinoma and personalized medicine in head and neck cancer. Ann Surg Oncol. 25:848–849. 2018.PubMed/NCBI View Article : Google Scholar
15	Lefebvre JL, Chevalier D, Luboinski B, Kirkpatrick A, Collette L and Sahmoud T: Larynx preservation in pyriform sinus cancer: Preliminary results of a European organization for research and treatment of cancer phase III trial. EORTC head and neck cancer cooperative group. J Natl Cancer Inst. 88:890–899. 1996.PubMed/NCBI View Article : Google Scholar
16	Lefebvre JL, Andry G, Chevalier D, Luboinski B, Collette L, Traissac L, de Raucourt D and Langendijk JA: EORTC Head and Neck Cancer Group. Laryngeal preservation with induction chemotherapy for hypopharyngeal squamous cell carcinoma: 10-year results of EORTC trial 24891. Ann Oncol. 23:2708–2714. 2012.PubMed/NCBI View Article : Google Scholar
17	Takehana K, Kodaira T, Tachibana H, Kimura K, Shimizu A, Makita C, Tomita N, Nishikawa D, Suzuki H, Hirakawa H, et al: Retrospective analysis of the clinical efficacy of definitive chemoradiotherapy for patients with hypopharyngeal cancer. Jpn J Clin Oncol. 46:344–349. 2016.PubMed/NCBI View Article : Google Scholar
18	Wolf GT, Bellile E, Eisbruch A, Urba S, Bradford CR, Peterson L, Prince ME, Teknos TN, Chepeha DB, Hogikyan ND, et al: Survival rates using individualized bioselection treatment methods in patients with advanced laryngeal cancer. JAMA Otolaryngol Head Neck Surg. 143:355–366. 2017.PubMed/NCBI View Article : Google Scholar
19	Muscat K, Bille A and Simo R: A guide to open surgical tracheostomy. Shanghai Chest. 1(4)2017.
20	Humidification and Hydration for tracheostomy and mechanical ventilation https://tracheostomyeducation.com/humidification-and-hydration/.
21	Tracheostomy guidelines St George's University Hospitals (HNS Foundation Trust) https://www.stgeorges.nhs.uk/gps-and-clinicians/clinical-resources/tracheostomy-guidelines/.
22	Monteiro AR, Garcia AR, Pereira TC, Macedo F, Soares RF, Pereira K, Serra T, Khouri L, Ribeiro J and Teixeira MM: ACE-27 as a prognostic tool of severe acute toxicities in patients with head and neck cancer treated with chemoradiotherapy: A real-world, prospective, observational study. Support Care Cancer. 29:1863–1871. 2021.PubMed/NCBI View Article : Google Scholar
23	Friedlander AH and Ettinger RL: Karnofsky performance status scale. Spec Care Dentist. 29:147–148. 2009.PubMed/NCBI View Article : Google Scholar
24	Zanoni DK, Patel SG and Shah JP: Changes in the 8th Edition of the American joint committee on cancer (AJCC) staging of head and neck cancer: Rationale and implications. Curr Oncol Rep. 21(52)2019.PubMed/NCBI View Article : Google Scholar
25	IBM SPSS Statistics Desktop 27.0 for Base and all Modules Academic Microsoft Windows Multilingual eAssembly https://www.ibm.com/support/pages/downloading-ibm-spss-statistics-27.
26	Garrett BE, Martell BN, Caraballo RS and King BA: Socioeconomic differences in cigarette smoking among sociodemographic groups. Prev Chronic Dis. 16(E74)2019.PubMed/NCBI View Article : Google Scholar
27	Goldenberg D, Ari EG, Golz A, Danino J, Netzer A and Joachims HZ: Tracheotomy complications: A retrospective study of 1130 cases. Otolaryngol Head Neck Surg. 123:495–500. 2000.PubMed/NCBI View Article : Google Scholar
28	Kissin F, Rysz M, Budziszewska M and Krajewski R: Comparison of criteria for elective tracheostomy in head and neck cancer surgery. Otolaryngol Pol. 75:20–26. 2021.PubMed/NCBI View Article : Google Scholar
29	Castling B, Telfer M and Avery BS: Complications of tracheostomy in major head and neck cancer surgery; a retrospective study of 60 consecutive cases. Br J Oral Maxillofac Surg. 32:3–5. 1994.PubMed/NCBI View Article : Google Scholar
30	Erickson EL, Katta J, Sun S, Shan L, Lemeshow S and Schofield ML: Retrospective review of acute post-tracheostomy complications and contributing risk factors. Clin Otolaryngol. 49:277–282. 2024.PubMed/NCBI View Article : Google Scholar
31	Bontempo LJ and Manning SL: Tracheostomy emergencies. Emerg Med Clin North Am. 37:109–119. 2019.PubMed/NCBI View Article : Google Scholar
32	Kejner AE, Castellanos PF, Rosenthal EL and Hawn MT: All-cause mortality after tracheostomy at a tertiary care hospital over a 10-month period. Otolaryngol Head Neck Surg. 146:918–922. 2012.PubMed/NCBI View Article : Google Scholar
33	Lee ST, Kim MG, Jeon JH, Jeong JH, Min SK, Park JY and Choi SW: Analysis of morbidity, mortality, and risk factors of tracheostomy-related complications in patients with oral and maxillofacial cancer. Maxillofac Plast Reconstr Surg. 38(32)2016.PubMed/NCBI View Article : Google Scholar
34	Halfpenny W and McGurk M: Analysis of tracheostomy-associated morbidity after operations for head and neck cancer. Br J Oral Maxillofac Surg. 38:509–512. 2000.PubMed/NCBI View Article : Google Scholar
35	Levy L, Smiley A and Latifi R: Mortality risk factors in patients admitted with the primary diagnosis of tracheostomy complications: An Analysis of 8026 patients. Int J Environ Res Public Health. 19(9031)2021.PubMed/NCBI View Article : Google Scholar
36	Saroul N, Puechmaille M, Lambert C, Hassan AS, Biau J, Lapeyre M, Mom T, Bernadach M and Gilain L: Prognosis in head and neck cancer: Importance of nutritional and biological inflammatory status. Otolaryngol Head Neck Surg. 166:118–127. 2022.PubMed/NCBI View Article : Google Scholar