Journal Article

Serum Albumin is an Important Prognostic Factor for Carotid Blowout Syndrome

Hsueh-Ju Lu, Kuo-Wei Chen, Ming-Huang Chen, Pen-Yuan Chu, Shyh-Kuan Tai, Cheng-Hwai Tzeng, Peter Mu-Hsin Chang and Muh-Hwa Yang

in Japanese Journal of Clinical Oncology

Volume 43, issue 5, pages 532-539
Published in print May 2013 | ISSN: 0368-2811
Published online March 2013 | e-ISSN: 1465-3621 | DOI: https://dx.doi.org/10.1093/jjco/hyt043
Serum Albumin is an Important Prognostic Factor for Carotid Blowout Syndrome

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Objective

Carotid blowout syndrome is a severe complication of head and neck cancer. High mortality and major neurologic morbidity are associated with carotid blowout syndrome with massive bleeding. Prediction of outcomes for carotid blowout syndrome patients is important for clinicians, especially for patients with the risk of massive bleeding.

Methods

Between 1 January 2001 and 31 December 2011, 103 patients with carotid blowout syndrome were enrolled in this study. The patients were divided into groups with and without massive bleeding. Prognostic factors were analysed with proportional hazard (Cox) regressions for carotid blowout syndrome-related prognoses. Survival analyses were based on the time from diagnosis of carotid blowout syndrome to massive bleeding and death.

Results

Patients with massive bleeding were more likely to have hypoalbuminemia (albumin <3.5 g/dl; P = 0.023). Univariate analysis of carotid blowout syndrome-related massive bleeding showed that treatment for carotid blowout syndrome (best supportive care, P = 0.000; embolization, P = 0.000), monocytosis (monocytes >1000 cells/μl, P = 0.041) and hypoalbuminemia (P = 0.010) were important to prognosis. Concurrent chemoradiotherapy (P = 0.007), elevated lactate dehydrogenase (>250 U/l; P = 0.050), local recurrence (P = 0.022) and hypoalbuminemia (P = 0.038) were related to poor prognosis in carotid blowout syndrome-related death. In multivariate analysis, best supportive care and hypoalbuminemia were independent factors for both carotid blowout syndrome-related massive bleeding (P = 0.000) and carotid blowout syndrome-related death (P = 0.013), respectively.

Conclusion

Best supportive care and serum albumin are important prognostic factors in carotid blowout syndrome. It helps clinicians to evaluate and provide better supportive care for these patients.

Keywords: head and neck cancer; carotid blowout syndrome; prognostic factor; serum albumin

Journal Article.  3299 words.  Illustrated.

Subjects: Medical Oncology

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