Association between postoperative complications and delayed adjuvant therapy following total laryngectomy: a retrospective cohort study.

Authors

Bianca Petra Taher, Serban Vifor Gabriel Bertesteanu, Raluca Grigore, Alexandru Nicolaescu, Gloria Simona Bertesteanu, Teodora Elena Schipor-Diaconu, Mihai Dumitru Tudosie, Irina Doinita Popescu, Bogdan Popescu, Paula Luiza Bejenaru, Alexandra Marin, Anca Ionela Cîrstea, Simona-Andreea Rujan

Published in

Journal of medicine and life. Volume 19. Issue 9. Pages 699-709.

Abstract

Total laryngectomy (TL) remains an essential treatment for selected patients with advanced laryngeal squamous cell carcinoma (LSCC), but postoperative complications may delay adjuvant radiotherapy (RT) or chemoradiotherapy (CRT). This retrospective cohort study evaluated the association between postoperative complications and time to adjuvant therapy after primary TL. The analytic cohort included patients who underwent primary TL for LSCC between January 2022 and December 2025 at a tertiary university hospital, had an indication for postoperative RT or CRT, initiated adjuvant therapy, and had a calculable time-to-treatment interval (TTI). Complications occurring before adjuvant treatment initiation were recorded and graded using the Clavien-Dindo classification. Delayed adjuvant therapy was defined as RT/CRT initiation more than 42 days after surgery; delay beyond 56 days was also assessed. Among 203 patients, postoperative complications occurred in 49 (24.1%), while 154 (75.9%) had an uncomplicated course. Median TTI was longer in patients with complications than in those without complications (56 vs 42 days; P < 0.001). Delay beyond 42 days occurred in 47/49 patients (95.9%) with complications versus 30/154 patients (19.5%) without complications (relative risk, 4.92; 95% CI, 3.55-6.82; P < 0.001). Delay beyond 56 days occurred in 23/49 patients (46.9%) with complications and in no uncomplicated patient. Pharyngocutaneous fistula, wound-related complications, and major complications requiring reintervention were associated with the longest treatment delays. Postoperative complications after primary TL were strongly associated with delayed initiation of adjuvant therapy, supporting prevention, early recognition, and prompt management of complications as important components of multidisciplinary oncological care.

PMID:
43005944
Bibliographic data and abstract were imported from PubMed on 10 Nov 2026.

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