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Major haemorrhage after non-surgical management of oropharyngeal squamous cell carcinoma

Published online by Cambridge University Press:  18 August 2022

S Leedman Open the ORCID record for S Leedman [Opens in a new window] ,
A Thompson ,
T Phillips  and
C Sader
S Leedman*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Sir Charles Gairdner Hospital, Perth, Australia
A Thompson
Affiliation:
Neurological Intervention and Imaging Service of Western Australia (‘NIISwa’), Sir Charles Gairdner Hospital, Perth, Australia
T Phillips
Affiliation:
Neurological Intervention and Imaging Service of Western Australia (‘NIISwa’), Sir Charles Gairdner Hospital, Perth, Australia
C Sader
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Sir Charles Gairdner Hospital, Perth, Australia
*
Author for correspondence: Dr Samuel Leedman, Department of Otolaryngology Head and Neck Surgery, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth, WA 6009, Australia E-mail: samleedman@gmail.com
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Abstract

Objectives

Major haemorrhage is a rare complication after chemoradiotherapy for oropharyngeal squamous cell carcinoma. This is managed by interventional neuroradiology with endovascular embolisation of the bleeding vessel. This study aimed to describe radiological and clinical predictors of haemorrhage.

Methods

A retrospective case series was conducted of all patients with oropharyngeal squamous cell carcinomas who suffered a major haemorrhage requiring embolisation during or after treatment with chemoradiotherapy or radiotherapy alone, between 2013 and 2021, in Western Australia.

Results

This study included 14 patients, in two groups: haemorrhage group (n = 70) and tumour stage matched non-haemorrhage group (n = 7). Patients who haemorrhaged had a larger average transverse axial tumour size on pre-treatment computed tomography (38 mm vs 22 mm; p = 0.02) and tumours tended to involve the proximal aspect of the offending bleeding vessel. All patients who haemorrhaged developed deep cavitating or ulcerative tumour bed changes on post-treatment imaging (p < 0.0001).

Conclusion

Tumour bed ulceration or cavitation appears to be highly predictive of haemorrhage in this patient cohort.

Keywords

OropharynxSquamous Cell CarcinomaHemorrhage
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 6 , June 2023 , pp. 667 - 672
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr S Leedman takes responsibility for the integrity of the content of the paper

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