Influence of previous radiotherapy on free tissue transfer in the head and neck region: evaluation of 455 cases.

Objective/hypothesis: The aim of this retrospective cohort study was to investigate the effect of prior radiotherapy (XRT) on the outcome of microvascular free tissue transfer in the head and neck region.

Methods: Four hundred fifty-five patients, subdivided into three groups, were analyzed. Groups I (no previous XRT, n=110), II (previous radiochemotherapy with 50 Gy focus dosage in the primary treatment regime for oral cancer, n=322), and III (secondary reconstruction after XRT-induced complications, n=23) were compared regarding flap success rate, postoperative complications, postoperative mortality, duration of intensive care (DOIC), and hospitalization (DOH).

Results: Flap success did not differ significantly across groups (I: 95.5%, II: 93.2%, III: 91.3%. Risk of postoperative complications was significantly lower for group I (12.7%) compared with groups II (23.9%) and III (39.1%). DOIC and DOH were significantly shorter for patients in group I than for those in groups II and III.

Conclusions: XRT before free tissue transfer does not significantly increase flap loss or postoperative mortality but does increase postoperative complications and length of hospitalization.