Carotid Artery Resection for Cancer of the Head and Neck

OBJECTIVE: To compare the morbidity and mortality associated with ligation and reconstruction of the carotid artery after resection. DESIGN: Cohort study. SETTING: Tertiary referral center and Veterans Affairs medical center. PATIENTS: Twenty consecutive patients who underwent carotid artery resection for metastatic squamous cell carcinoma between January 1985 and June 1992. RESULTS: Seven (58%) of 12 patients with ligation suffered neurological sequelae compared with one (13%) of eight patients with interposition grafts (P < .05). Six of eight patients with neurological sequelae had delayed onset of complications. Local control of tumor was achieved in 14 (74%) of 19 patients overall. Median survival was 6.3 months, and the 1-year disease-free survival rate was 16% (three patients). CONCLUSION: Carotid artery replacement is superior to ligation in avoiding the neurological complications of carotid artery resection. Carotid artery resection can provide local control of tumor but fails to achieve a high rate of disease-free survival.