Primary surgical treatment versus salvage surgery: Results of free flap reconstruction performed in 100 patients with oropharyngeal cancer

Banaszewski, Jacek; Pabiszczak, Maciej; Balcerowiak, Andrzej; Pastusiak, Tomasz; Andruszko, Agata

doi:10.1016/j.suronc.2018.12.005

Cited by 3 publications

(4 citation statements)

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“…However, salvage laryngectomy may be associated with significantly worse disease‐free survival (DFS) 26 . For oropharyngeal SCC, upfront nonsurgical therapy followed by SS was associated with worse control rates, difficulties in reconstruction, and greater postsurgical complications 27 . In this article, which is the first large‐population national database study comparing PS versus SS for SNM across stage, histology, and primary site, PS was shown to result in improved OS outcomes compared to SS.…”

Section: Discussionmentioning

confidence: 89%

“…More importantly, SS is a rarely selected treatment option for SNM 24 ; therefore, treatment recommendations tend to be based on institutional and surgeon preferences. In the head and neck literature, comparing PS and SS OS outcomes have been mainly limited to laryngeal SCC 25,26 and oropharyngeal SCC 27 . In the setting of laryngeal SCC, Sullivan and colleagues demonstrated similar 5‐year OS between primary and salvage total laryngectomy 25 .…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of Primary Versus Salvage Surgery for Sinonasal Malignancies: A Population‐Based Analysis

et al. 2020

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Objectives/Hypothesis There exists a lack of consensus on the optimal sequence of treatment for many sinonasal malignancies (SNMs). This study compares the overall survival (OS) outcomes for primary surgery (PS) versus salvage surgery (SS) in SNM patients across stage, histology, and primary site. Study Design Retrospective database review. Methods The National Cancer Database was queried for all SNM cases treated with multimodal surgical and nonsurgical therapy between 2004 and 2015. Logistic regression identified predictors of SS. Cox proportional hazards models evaluated predictors of mortality, and Kaplan‐Meier log‐rank test assessed OS outcomes. Results Our SNM cohort consisted of 3,011 patients (PS = 2,804; SS = 207). SS patients had significantly longer postoperative hospital stays (P = .009) and increased rates of 30‐day (P < .001) and 90‐day mortality (P < .001) compared to PS. On multivariate logistic regression, predictors of undergoing SS included sinonasal undifferentiated carcinoma histology (odds ratio = 2.72; 95% confidence interval [CI]: 1.16‐6.66; P = .024). On multivariate Cox proportional hazards analyses among SS patients, late‐stage disease (hazard ratio [HR] = 4.80; 95% CI: 1.46‐15.8; P = .01) and positive surgical margins (HR = 2.31; 95% CI: 1.29‐4.13; P = .005) portended significantly worse OS. In the propensity score–matched cohort controlling for stage and histology, PS had significantly improved OS compared to SS (P = .007). Compared to SS, PS also had improved OS in subgroup analyses for patients with late‐stage disease (P = .026) and squamous cell carcinoma histology (P = .006). Conclusions In our SMN cohort, PS resulted in improved OS outcomes compared to SS independent of stage and histology. Consideration may be given to primary surgical resection for SMN whenever feasible, though a targeted, individualized approach is warranted. Level of Evidence 3 Laryngoscope, 131:E710–E718, 2021

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Outcomes of Primary Versus Salvage Surgery for Sinonasal Malignancies: A Population‐Based Analysis

et al. 2020

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“…The complications caused by previous radiotherapy and chemotherapy will also have adverse effect on the therapy. [8][9][10] In addition, resection of widely spread tumors in head and neck region always leads to appearance changing, dysfunction of swallowing, chewing and others, which profoundly impact their quality of life (QOL). Accordingly, extensively recurrent head and neck cancers raise the treatment challenges both in therapy selection and implementation for surgical team.…”

Section: Introductionmentioning

confidence: 99%

Quality of life after salvage surgery for extensively recurrent head and neck cancer patients: a prospective, observational, real-world study

Zhang

Liu

et al. 2022

Preprint

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Purpose Multiple studies on salvage surgery (SS) implied the efficacy but the estimate of quality of life (QOL) after SS was poorly analyzed. Our study aimed to examine the quality of life before and after salvage surgery using the validated instruments QLQ-H&N35 and UW-QOL and investigate the value of salvage surgery by quantifying survival outcomes. Materials and methods Among 21 patients, preoperative and postoperative QOL were accessed using QLQ-H&N35 and UW-QOL questionnaire. Patients’ demographic characteristics, history of treatment, recurrent tumor characteristics, salvage surgery details and follow-up date were abstracted from our prospective database. Statistical analysis methods included Wilcoxon signed-rank test, descriptive analysis and Kaplan-Meier method. Results The overall quality of life was significantly improved after salvage surgery. Pain was significantly relieved whilst diminished functions were hinted with significant differences in UW-QOL domains swallowing, chewing, speech, shoulder, taste, saliva and in QLQ-H&N35 domains swallowing, speech, social eating, senses, dry mouth, sticky saliva as p༜0.05. The median disease-free survival of whole 21 patients was 5 months (range 0-73) and the median overall survival was 13 months (range 1-73). Conclusions The quality of life after salvage surgery for extensively recurrent head and neck cancer is acceptable. Despite the dysfunctions such as dysphagia and dry mouth, it does relieve the pain and improve the short-term overall QOL of patients. Further studies on quality of life before and after salvage surgery in HNSCC are obviously needed. In the future, postoperative functional recovery training also needs attention during follow up.

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“…Больные с рецидивами плоскоклеточного рака головы и шеи -достаточно сложная для лечения группа ввиду того, что к моменту постановки диагноза рецидива весь арсенал лечебных методов уже использован [1]. При резектабельности рецидива рекомендуется хирургическое лечение, однако зачастую результаты лечения остаются неудовлетворительными из-за сложности получения чистого края резекции и изменения топографо-анатомических взаимоотношений между рецидивной опухолью и нормальными тканями, а также дефицита тканей для выполнения пластики [2]. Все это снижает радикальность лечения и выживаемость пациентов.…”

Section: Introductionunclassified

Recurrent squamous cell carcinoma of head and neck: results of treatment in the Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine in 2012–2016

Карабут¹,

Важенин²,

Мозерова³

et al. 2020

Opuholi golovy i šei

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Introduction. There is no treatment for recurrence of head and neck squamous cell carcinoma, which significantly increases the overall survival (OS) of patients.The study objective is to analyze the results of treatment of patients with recurrences of squamous cell carcinoma of the head and neck and to assess the impact of risk factors for relapse, as well as different treatment options for relapse on OS. Materials and methods. In the period from 2012 to 2016, 182 patients with relapses of squamous cell carcinoma of the larynx, oral cavity and tongue received treatment in the Chelyabinsk regional clinical center of Oncology and nuclear medicine. The group 1 included 66 patients with resectable relapse who were operated. The group 2 consisted of 25 patients who received a course of radiation therapy. The group 3 consisted of 46 patients who underwent chemotherapeutic treatment of relapse. The group 4 was represented by combined treatment (surgery + radiation therapy), this group included 9 people. The group 5 consisted of those of patients who were not specifically treated for relapse because of the low Karnofsky index in patients (<70 %). Results. OS among patients who received special treatment was significantly higher compared with the group of symptomatic therapy. The median OS in the special treatment group was 40 months, and without it – 18 months. Comparing all types for treating relapse, the highest rates of OS were in the surgical treatment group. OS rates in combined therapy group and radiotherapy group were comparable rate in the radiotherapy. The lowest OS rate was after chemotherapy (only 21 months).Conclusion. Surgery is the optimal method for treating recurrent squamous cell carcinoma of head and neck, if it is resectable. If surgical treatment is not possible, no other method significantly increases the OS. If the overall status of the patient is normal, re-radiation or polychemotherapy may be performed. A limited category of patients can be subjected to combined treatment for relapse.

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Primary surgical treatment versus salvage surgery: Results of free flap reconstruction performed in 100 patients with oropharyngeal cancer

Cited by 3 publications

References 24 publications

Outcomes of Primary Versus Salvage Surgery for Sinonasal Malignancies: A Population‐Based Analysis

Outcomes of Primary Versus Salvage Surgery for Sinonasal Malignancies: A Population‐Based Analysis

Quality of life after salvage surgery for extensively recurrent head and neck cancer patients: a prospective, observational, real-world study

Recurrent squamous cell carcinoma of head and neck: results of treatment in the Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine in 2012–2016

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