Biophysical properties of the neck skin indicating potential complications of salvage surgery for laryngeal/hypopharyngeal cancer

Abstract

Background

Chemoradiation therapy is standard practice for hypopharyngeal and laryngeal cancer, but its impact on skin health can cause complications if salvage surgery is required.

Aims/Objectives

To develop simple objective indices for the early detection of complications following head-and-neck salvage surgery.

Material and Methods

Preoperatively and on postoperative days 1, 3, 5 and 7, we measured skin hardness (N), interstitial liquid content (П) and intracellular liquid content (W) as biophysical properties in patients who underwent post-CRT salvage therapy and those who underwent total organ resection without CRT as controls. We then analyzed these data in relation to occurrence of complications.

Results

In 11 patients undergoing salvage surgery and 23 controls, complications tended to be higher (p = .54) in the salvage group. N values were significantly higher in the salvage and complication groups on days 5 and 7, П values were higher in the complication group on day 7, and W values were lower in the complication group on day 3 and in the salvage group preoperatively and on days 1 and 5.

Conclusions and significance

N, П and W are useful measurements for the early identification of patients likely to develop complications.

Chinese Abstract

背景：放化疗是下咽癌和喉癌的标准治疗方法, 但如果需要急救手术, 它对皮肤健康

的影响可能会导致并发症。

目的：为早期检测头颈部急救手术后并发症制定简单的客观指标。

材料和方法：术前和术后第1、3、5和7天, 我们测量了皮肤硬度（N）、间质液体含量（G）和细胞内液体含量（W）, 将它们作为在接受CRT后抢救治疗的患者和接受全器官切除而没有CRT作为控制的患者的生物物理性质。然后, 我们分析了这些与并发症相关的数据。

结果：在接受抢救手术的11名患者和23名对照者中, 在抢救组中并发症倾向于更高（p=.54）。在接受抢救并产生并发症的组群中, N值在第5天和第7天显著较高, 并发症组的G值在第7天较高, 而W值对于并发症组在第3天、抢救组在术前和第1天和第5天较低。

结论和意义：N、G和W是早期识别可能出现并发症的患者的有用指标。

Keywords:

• Salvage surgery
• complications
• hardness of the skin
• liquid content of the skin

Ethical approval

This research was conducted ethically in accordance with the World Medical Association of Helsinki and was approved by the Ethics Committee of Medical Research, University of Occupational and Environmental Health, Japan (UOEHCRB20-263). Informed consent was obtained from all individual participants included in the study.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by a Grant-in-Aid for Young Scientists [No. 19K18752] to J-I. O. from the Japan Society for the Promotion of Science (JSPS).