Pharyngocutaneous fistula: a common complication following laryngectomy: JAMA

The results revealed that all the 550 patients (mean [SD] age, 64 [10.4] years; men, 465 [85%]) met inclusion criteria. Out of the entire sample, pharyngocutaneous fistula occurred in 127 patients (23%).

The difference in locoregional control between the group of patients with pharyngocutaneous fistula (75%) and the non– pharyngocutaneous fistula (72%) group was 3% (95% CI, −6% to 12%).

The difference in overall survival between the group with pharyngocutaneous fistula (44%) and the non– pharyngocutaneous fistula group (52%) was 8% (95% CI, −2% to 20%). The difference in disease-free survival between pharyngocutaneous fistula and non– pharyngocutaneous fistula groups was 6% (95% CI, −4% to 16%).

Furthermore, in the multivariable model, patients with pharyngocutaneous fistula were at a 2-fold higher rate of distant metastases (hazard ratio, 2.00; 95% CI, 1.22 to 3.27). Distant control was reduced in those with pharyngocutaneous fistula, a 13% (95% CI, 3% to 21%) difference in 5-year distant control.

As a result, the authors concluded that development of pharyngocutaneous fistula after salvage laryngectomy is associated with an increased risk for the development of distant metastases.

doi:10.1001/jamaoto.2021.1545