Korean J Otorhinolaryngol-Head Neck Surg.  2022 Oct;65(10):610-616. 10.3342/kjorl-hns.2022.00283.

Neoadjuvant Immunotherapy Following Definitive Surgical Treatment for Locoregionally Advanced Head and Neck Cancer: Perioperative Complication and Surgical Outcomes

• Park JH
• Park YM
• Kim DH
• Kim SH
• Kim HR
• Koh YW

• KMID: 2534450
• DOI: http://doi.org/10.3342/kjorl-hns.2022.00283

Abstract

Background and Objectives
We analyzed surgical outcomes, perioperative complications, and mortality in head and neck squamous cell carcinoma (HNSCC) in patients who underwent curative surgery following neoadjuvant immunotherapy.
Subjects and Method
The records of 36 HNSCC patients who underwent curative surgery with neoadjuvant immunotherapy and 69 HNSCC patients who received neoadjuvant chemotherapy were analyzed.
Results
The average operation time was 315 minutes, and the average bleeding volume was 167 cc. The average length of hospital stay was 21 days. When evaluating surgical margin status, we found 24 patients (66.6%) who exhibited a negative margin. We found no case where surgery was impossible due to progression of the lesion during neoadjuvant immunotherapy. Compared to the neoadjuvant chemotherapy group, neoadjuvant immunotherapy group showed acceptable perioperative safety and complication profile. The postoperative complication rate was 19.4% in the neoadjuvant immunotherapy group and 13.0% in the neoadjuvant chemotherapy group (p=0.386). There were no serious complications during the recovery period after surgery or instances of death due to complications.
Conclusion
In HNSCC patients, there was no increase in the incidence of complications or mortality related to curative surgery after neoadjuvant immunotherapy.

Keyword

Chemotherapy; Immunotherapy; Neoadjuvant therapy; Postoperative complications