Carotid blowout in patients with head and neck cancer: associated factors and treatment outcomes.

BACKGROUND The purpose of this study was to investigate factors associated with carotid blowout in the cervical portion of patients with head and neck cancer in a large cohort. METHODS We reviewed patients with head and neck cancer and identified those with carotid blowout. Variables of patients with and without carotid blowout were compared and associated factors were investigated by logistic regression model. RESULTS A total of 2590 patients were included in the final analysis and 102 patients (3.9%) developed carotid blowout in the cervical region. Body mass index (BMI) <22.5 kg/M(2) , primary site in the hypopharynx or oropharynx, open wound in the neck requiring wet dressing, radical neck dissection, and total radiation dose to the neck ≥70 Gy were independent factors associated with carotid blowout. CONCLUSION After completion of treatment in patients with head and neck cancer, carotid blowout was an uncommon complication with catastrophic results. Recognition of associated factors helps physicians to identify those at risk.