Evidence map›Paper›PMID 29340771›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2018

Predictive factors for pharyngocutaneous fistulization after total laryngectomy: a Dutch Head and Neck Society audit.

Liset Lansaat, Vincent van der Noort, Simone E Bernard, Simone E J Eerenstein, Boudewijn E C Plaat, Ton A P M Langeveld, Martin Lacko, Frans J M Hilgers, Remco de Bree, Robert P Takes and 2 more

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In one paragraph

Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
3.9field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.

  1. Pharyngocutaneous fistula following total laryngectomy: a systematic review of risk factors and management strategies (2010-2024).European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
    Pooled it
  2. Risk factors of pharyngocutaneous fistula after total laryngectomy: a systematic review and meta-analysis.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2020
    Pooled it
  3. Factors associated with occult ipsilateral and contralateral nodal metastasis in resectable lateralized laryngeal and hypopharyngeal malignancies.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
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  7. Reconstruction for Salvage Laryngectomy With Limited Pharyngectomy.JAMA otolaryngology-- head & neck surgery · 2024
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  11. Risk Factors for Pharyngocutaneous Fistula Following Total Laryngectomy.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2023
    Article
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  14. Low skeletal muscle mass assessed directly from the 3rd cervical vertebra can predict pharyngocutaneous fistula risk after total laryngectomy in the male population.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2022
    Article
  15. Time interval between (chemo)radiotherapy and subsequent laryngectomy is not prognostic for post operative complications and survival.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2021
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  16. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 6 institutions in 1 country.

Liset LansaatDepartment of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
Vincent van der NoortDepartment of Biometrics, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
Simone E BernardDepartment of Otorhinolaryngology-Head and Neck Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
Simone E J EerensteinDepartment of Otolaryngology-Head and Neck Surgery, VU Medical Center, Amsterdam, The Netherlands.
Boudewijn E C PlaatDepartment of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Groningen, Groningen, The Netherlands.
Ton A P M LangeveldDepartment of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Martin LackoDepartment of Otorhinolaryngology-Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
Frans J M HilgersDepartment of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
Remco de BreeDepartment of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
Robert P TakesDepartment of Otorhinolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Michiel W M van den BrekelDepartment of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands. m.vd.brekel@nki.nl.ORCID http://orcid.org/0000-0003-1212-6092
Dutch Head and Neck Society
Amsterdam UMC Location University of Amsterdam · NLErasmus MC · NLRadboud University Nijmegen · NLThe Netherlands Cancer Institute · NLUniversity Medical Center Groningen · NLLeiden University Medical Center · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIncidences of pharyngocutaneous fistulization (PCF) after total laryngectomy (TL) reported in the literature vary widely, ranging from 2.6 to 65.5%. Comparison between different centers might identify risk factors, but also might enable improvements in quality of care. To enable this on a national level, an audit in the 8 principle Dutch Head and Neck Centers (DHNC) was initiated.

methodsA retrospective chart review of all 324 patients undergoing laryngectomy in a 2-year (2012 and 2013) period was performed. Overall PCF%, PCF% per center and factors predictive for PCF were identified. Furthermore, a prognostic model predicting the PCF% per center was developed. To provide additional data, a survey among the head and neck surgeons of the participating centers was carried out.

resultsOverall PCF% was 25.9. The multivariable prediction model revealed that previous treatment with (chemo)radiotherapy in combination with a long interval between primary treatment and TL, previous tracheotomy, near total pharyngectomy, neck dissection, and BMI < 18 were the best predictors for PCF. Early oral intake did not influence PCF rate. PCF% varied quite widely between centers, but for a large extend this could be explained with the prediction model. PCF performance rate (difference between the PCF% and the predicted PCF%) per DHNC, though, shows that not all differences are explained by factors established in the prediction model. However, these factors explain enough of the differences that, compensating for these factors, hospital is no longer independently predictive for PCF.

conclusionsThis nationwide audit has provided valid comparative PCF data confirming the known risk factors from the literature which are important for counseling on PCF risks. Data show that variations in PCF% in the DHNCs (in part) are explainable by the variations in these predictive factors. Since elective neck dissection is a major risk factor for PCF, it only should be performed on well funded indication.

Indexed as

LaryngectomyAdultAgedCutaneous FistulaFemaleHumansIncidenceMaleMedical AuditMiddle AgedNeck DissectionOutcome Assessment, Health CarePharyngeal DiseasesPharyngectomyPostoperative ComplicationsRespiratory Tract FistulaNational auditPharyngocutaneous fistulizationPredicted pharyngocutaneous fistulization percentagesPredictive factorsTotal laryngectomy

Identifiers

PMID29340771
OpenAlexW2784073154

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.