ICHNO-ECHNO 2022 - Abstract Book

S81

ICHNO-ECHNO 2022

Conclusion High dose of cisplatin could be used in different CKD stages with very low rate of renal toxicity events and AKI-CKD onset.

PO-0127 Tranexamic acid in head and neck procedures: A systematic review and meta-analysis of RCT's

H. Alsubaie 1 , A. Abu-Zaid 2 , S. Sayed 3 , A. Pathak 3 , M. Almayouf 4 , M. Albarrak 4 , S. Aldhahri 4,5 , K. Al-Qahtani 6,5

1 King Abdullah Medical City, Otorhinolaryngology, Head and Neck Surgery, Makkah, Saudi Arabia; 2 University of Tennessee Health Science Center, College of Graduate Health Sciences, Tennessee, Texas, USA; 3 CancerCare Manitoba, University of Manitoba, Head and Neck Oncology, Winnipeg, Manitoba, Canada; 4 King Fahad Medical City, Otorhinolaryngology, Head and Neck Surgery, Riyadh, Saudi Arabia; 5 College of Medicine, King Saud University, Otorhinolaryngology, Head and Neck Surgery, Riyadh, Saudi Arabia; 6 King Fahad Medical City, Otorhinolaryngology - Head and Neck Surgery, Riyadh, Saudi Arabia Purpose or Objective We conducted a meta-analysis of all randomized controlled trials (RCTs) that examined the benefits of tranexamic acid (TXA) among cancer patients undergoing head and neck (H&N) procedures. Materials and Methods We screened five databases from inception until 20-June-2021 and evaluated the risk of bias of the eligible studies. We pooled continuous outcomes using the weighted mean difference (WMD) with a 95% confidence interval (CI). Results Five studies comprising seven RCTs met the inclusion criteria. This meta-analysis included 540 patients; 265 and 275 patients were assigned to the TXA and control group, respectively. Overall, the included RCTs revealed a low risk of bias. The volume of postoperative bleeding was significantly lower in favor of the TXA group compared with the control group (n=7 RCTs, WMD=–51.33 ml, 95% CI [–101.47, –1.2], p=0.04). However, no significant difference was found between both groups regarding the volume of intraoperative bleeding (n=6 RCTs, WMD=–3.48 ml, 95% CI [–17.11, 10.15], p=0.62), postoperative hemoglobin (n=3 RCTs, WMD=0.42 mg/dl, 95% CI [–0.27, 1.11], p=0.23), duration of drainage tube removal (n=4 RCTs, MD=– 0.41 days, 95% CI [–1.14, 0.32], p=0.27), and operation time (n=6 RCTs, WMD=1.59 minutes, 95% CI [–10.09, 13.27], p=0.79). TXA was safe and did not culminate in thromboembolic events or major coagulation derangements. Conclusion TXA administration is safe and significantly reduces the volume of postoperative bleeding. However, no difference is identified between TXA and control groups regarding the volume of intraoperative bleeding, postoperative hemoglobin level, duration of drainage tube removal, and operation time. 1 Inselspital Bern University Hospital, University Department of Ear, Nose, Throat, Head and Neck Surgery, Bern, Switzerland Purpose or Objective Lymph node metastases are associated with poor prognosis in head and neck squamous cell carcinoma (HNSCC). Neck dissection (ND) is often performed prior to or after (chemo)radiation (CRT) and is an integral part of HNSCC treatment strategies. The impact of CRT delivered prior to ND on lymph node yield (LNY) and lymph node ratio (LNR) has not been comprehensively investigated. Materials and Methods A retrospective cohort study was conducted from January 2014 to 30 June 2019 at the University Hospital of Bern, Switzerland. We included 252 patients with primary HNSCC who underwent NDs either before or after CRT. LNY and LNR were compared in patients undergoing ND prior to or after CRT. A total of 137 and 115 patients underwent modified radical ND (levels I to V) and selective ND, respectively. The impact of several features on survival and disease control was assessed. Results Of the included patients, 170 were male and 82 were females. There were 141 primaries from the oral cavity, 55 from the oropharynx, and 28 from the larynx. ND specimens showed a pN0 stage in 105 patients and pN+ in 147. LNY, but LNR was not significantly higher in patients undergoing upfront ND than in those after CRT (median: 38 vs. 22, p < 0.0001). Cox hazard ratio regression showed that an LNR ≥ 6.5% correlated with poor overall (HR 2.42, CI 1.12-4.89, p = 0.014) and disease-free survival (HR 3.416, CI 1.54-754, p = 0.003) in MRND. Conclusion ND after CRT leads to significantly reduced LNY. An LNR 6.5% is an independent risk factor for decreased overall, disease- free, and distant metastasis-free survival for MRND. PO-0128 Oncological outcome of lymph node yield and ratio in selective and modified radical neck dissection S. Sheppard 1 , L. Frech 1 , R. Giger 1 , L. Nisa 1