Diabetes mellitus in major head and neck cancer surgery: Systematic review and meta-analysis

Mathew P. Caputo; Sepehr Shabani; Rahul Mhaskar; Caitlin McMullen; Tapan A. Padhya; Matthew J. Mifsud

doi:10.1002/hed.26349

Diabetes mellitus in major head and neck cancer surgery: Systematic review and meta-analysis

Mathew P. Caputo, Sepehr Shabani, Rahul Mhaskar, Caitlin McMullen, Tapan A. Padhya, Matthew J. Mifsud

Research output: Contribution to journal › Review article › peer-review

13 Scopus citations

Abstract

Background: Diabetes mellitus (DM) is a risk factor for surgical complications and a common comorbidity in the setting of head and neck (H&N) cancer. Our objective was to determine if DM is associated with increased rates of H&N cancer surgery complications. Methods: We conducted a search of Pubmed, Embase, and the national clinical trials database focusing on H&N cancer surgery or free flap reconstruction and diabetes. Two reviewers screened studies by title/abstract and then full text. We then collected data using a pre-made template. Meta-analysis was performed using Revman 5.3. Results: Of the 272 results from Pubmed and 559 from Embase, we selected 16 studies for inclusion. Meta-analysis revealed DM was associated with increased rates of flap failure (risk ratio [RR] = 1.83 95% confidence interval [CI], 1.18-2.85; P =.007) and local complications (RR = 1.87 95% CI, 1.24-2.80; P <.00001). Conclusion: Although DM is associated with increased risk of flap failure and local H&N cancer surgery complications, further research is required to optimize care in this population.

Original language	English (US)
Pages (from-to)	3031-3040
Number of pages	10
Journal	Head and Neck
Volume	42
Issue number	10
DOIs	https://doi.org/10.1002/hed.26349
State	Published - Oct 1 2020
Externally published	Yes

Keywords

diabetes mellitus
free-flap failure
head and neck cancer
head and neck microvascular reconstruction
perioperative surgical complications

ASJC Scopus subject areas

Otorhinolaryngology

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10.1002/hed.26349

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title = "Diabetes mellitus in major head and neck cancer surgery: Systematic review and meta-analysis",

abstract = "Background: Diabetes mellitus (DM) is a risk factor for surgical complications and a common comorbidity in the setting of head and neck (H&N) cancer. Our objective was to determine if DM is associated with increased rates of H&N cancer surgery complications. Methods: We conducted a search of Pubmed, Embase, and the national clinical trials database focusing on H&N cancer surgery or free flap reconstruction and diabetes. Two reviewers screened studies by title/abstract and then full text. We then collected data using a pre-made template. Meta-analysis was performed using Revman 5.3. Results: Of the 272 results from Pubmed and 559 from Embase, we selected 16 studies for inclusion. Meta-analysis revealed DM was associated with increased rates of flap failure (risk ratio [RR] = 1.83 95% confidence interval [CI], 1.18-2.85; P =.007) and local complications (RR = 1.87 95% CI, 1.24-2.80; P <.00001). Conclusion: Although DM is associated with increased risk of flap failure and local H&N cancer surgery complications, further research is required to optimize care in this population.",

keywords = "diabetes mellitus, free-flap failure, head and neck cancer, head and neck microvascular reconstruction, perioperative surgical complications",

author = "Caputo, {Mathew P.} and Sepehr Shabani and Rahul Mhaskar and Caitlin McMullen and Padhya, {Tapan A.} and Mifsud, {Matthew J.}",

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T2 - Systematic review and meta-analysis

AU - Caputo, Mathew P.

AU - Shabani, Sepehr

AU - Mhaskar, Rahul

AU - McMullen, Caitlin

AU - Padhya, Tapan A.

AU - Mifsud, Matthew J.

PY - 2020/10/1

Y1 - 2020/10/1

N2 - Background: Diabetes mellitus (DM) is a risk factor for surgical complications and a common comorbidity in the setting of head and neck (H&N) cancer. Our objective was to determine if DM is associated with increased rates of H&N cancer surgery complications. Methods: We conducted a search of Pubmed, Embase, and the national clinical trials database focusing on H&N cancer surgery or free flap reconstruction and diabetes. Two reviewers screened studies by title/abstract and then full text. We then collected data using a pre-made template. Meta-analysis was performed using Revman 5.3. Results: Of the 272 results from Pubmed and 559 from Embase, we selected 16 studies for inclusion. Meta-analysis revealed DM was associated with increased rates of flap failure (risk ratio [RR] = 1.83 95% confidence interval [CI], 1.18-2.85; P =.007) and local complications (RR = 1.87 95% CI, 1.24-2.80; P <.00001). Conclusion: Although DM is associated with increased risk of flap failure and local H&N cancer surgery complications, further research is required to optimize care in this population.

AB - Background: Diabetes mellitus (DM) is a risk factor for surgical complications and a common comorbidity in the setting of head and neck (H&N) cancer. Our objective was to determine if DM is associated with increased rates of H&N cancer surgery complications. Methods: We conducted a search of Pubmed, Embase, and the national clinical trials database focusing on H&N cancer surgery or free flap reconstruction and diabetes. Two reviewers screened studies by title/abstract and then full text. We then collected data using a pre-made template. Meta-analysis was performed using Revman 5.3. Results: Of the 272 results from Pubmed and 559 from Embase, we selected 16 studies for inclusion. Meta-analysis revealed DM was associated with increased rates of flap failure (risk ratio [RR] = 1.83 95% confidence interval [CI], 1.18-2.85; P =.007) and local complications (RR = 1.87 95% CI, 1.24-2.80; P <.00001). Conclusion: Although DM is associated with increased risk of flap failure and local H&N cancer surgery complications, further research is required to optimize care in this population.

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KW - head and neck microvascular reconstruction

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Diabetes mellitus in major head and neck cancer surgery: Systematic review and meta-analysis

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