Diabetes mellitus in major head and neck cancer surgery: Systematic review and meta-analysis
Mathew P. Caputo BA
Department of Otolaryngology—Head & Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
Search for more papers by this authorSepehr Shabani MD
Department of Otolaryngology—Head & Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
Search for more papers by this authorRahul Mhaskar MPH, PhD
Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
Search for more papers by this authorCaitlin McMullen MD
Department of Head and Neck and Endocrine Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
Search for more papers by this authorTapan A. Padhya MD
Department of Otolaryngology—Head & Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
Department of Head and Neck and Endocrine Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
Search for more papers by this authorCorresponding Author
Matthew J. Mifsud MD
Department of Otolaryngology—Head & Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
Correspondence
Matthew J. Mifsud, Department of Otolaryngology—Head & Neck Surgery, University of South Florida- Morsani College of Medicine, 12901 Bruce B. Downs Blvd., MDC 73, Tampa, FL 33612.
Email: [email protected]
Search for more papers by this authorMathew P. Caputo BA
Department of Otolaryngology—Head & Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
Search for more papers by this authorSepehr Shabani MD
Department of Otolaryngology—Head & Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
Search for more papers by this authorRahul Mhaskar MPH, PhD
Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
Search for more papers by this authorCaitlin McMullen MD
Department of Head and Neck and Endocrine Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
Search for more papers by this authorTapan A. Padhya MD
Department of Otolaryngology—Head & Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
Department of Head and Neck and Endocrine Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
Search for more papers by this authorCorresponding Author
Matthew J. Mifsud MD
Department of Otolaryngology—Head & Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
Correspondence
Matthew J. Mifsud, Department of Otolaryngology—Head & Neck Surgery, University of South Florida- Morsani College of Medicine, 12901 Bruce B. Downs Blvd., MDC 73, Tampa, FL 33612.
Email: [email protected]
Search for more papers by this authorAn earlier version of this manuscript was presented at AAO-HNSF 2019 Annual Meeting & OTO Experience in New Orleans, LA, at September, 2019.
Funding information: USF Morsani College of Medicine, Grant/Award Number: 2019 Summer Scholarly Award Experience Grant
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.
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