Oliver Blanshard, Sarah Jones, Peter M Clarke, Jonathan M Bernstein
Five-year survival in this oncologic cohort was half the published rate. Ongoing attrition supports supernumerary implant placement and lifelong management.
BACKGROUND: Published survival rates for bone-anchored craniofacial implants exceed 85%, but derive largely from mixed populations. Whether these apply to head and neck oncologic surgery remains uncertain.
METHODS: Retrospective survival analysis of implants placed for prosthetic rehabilitation following extirpative surgery at a UK center (2005-2024).
RESULTS: Survival among 184 implants in 51 patients was 94%, 60% and 46% at 1, 3 and 5 years (median 4.1 years, 95% CI 3.0-6.3). 77% of patients received radiation therapy. Median dose to implant region was 57 Gy. On univariate analysis, radiation, diabetes and older age predicted implant loss. On multivariable analysis, diabetes, present in three patients, predicted implant loss (HR 4.0, 95% CI 1.5-10.7), while radiation therapy trended towards implant loss. Annual hazard rates demonstrated continual attrition without plateau.
CONCLUSIONS: Five-year survival in this oncologic cohort was half the published rate. Ongoing attrition supports supernumerary implant placement and lifelong management.