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 journalReview articlepeer-review

8 Scopus citations


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 languageEnglish (US)
Pages (from-to)3031-3040
Number of pages10
JournalHead and Neck
Issue number10
StatePublished - Oct 1 2020
Externally publishedYes


  • 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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