Carotid artery resection and reconstruction in patients with squamous cellcarcinomas of the neck

The authors performed a retrospective review of their 10-year experience of carotid artery resection with vascular reconstruction for advanced squamou s cell carcinoma of the neck. From 1986 to 1997, four patients underwent el ective and one patient acute carotid artery resection with revascularizatio n at the Department of Otolaryngology, Albert Szent-Gyorgyi Medical Univers ity, Szeged, Hungary. Primary lesions were three laryngeal and two hypophar yngeal squamous cell carcinomas. All five resected specimens had metastatic invasion by tumor of the carotid adventitia on pathological examination, w hile only four specimens exhibited tumorous destruction of the arterial wal l. No cerebrovascular accident occurred in any patient, although one patien t died postoperatively from cardiac failure. The four remaining;patients di ed of local-regional recurrences or metastatic disease within 17 months aft er their carotid artery resections. Our findings show that carotid artery r esection with replacement is superior to ligation alone in avoiding neurolo gical complications. This approach can provide local control of tumor, but may fail to achieve significant disease-free survival.