Salvage surgery for oropharyngeal squamous cell carcinomas: A retrospective study from 2005 to 2013

Abstract

According to the high morbimortality, it is important to carefully select the right patients for surgery.

The Current Role of Salvage Surgery in Recurrent Head and Neck Squamous Cell Carcinoma

“…While it is difficult to compare data across trials in the absence of well accepted guidelines, reported rates of complications following SS for all head and neck subsites ranged from 23% to 67% [ 3 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. In the absence of uniformity in the reporting of complications, comparison is challenging.…”

“…Many studies have identified advanced primary tumor and nodal stage, short disease-free interval (DFI), nonlaryngeal cancer site, and previous RT as oncologic risk factors for poor outcome after SS [ 9 , 17 , 23 , 24 , 25 , 26 ].…”

“…Some studies address salvage treatment for specific subsites (e.g., oral cavity and oropharynx, larynx only, larynx and hypopharynx, oropharynx only, etc.) [ 11 , 13 , 14 , 15 , 17 , 27 , 28 ] while others analyze the results of all salvage modalities pooling together surgery and non-surgical salvage modalities [ 23 ] or report results after failure of a specific primary treatment like CRT [ 3 , 16 ]. In a study addressing SS for all head and neck sites, Hamoir et al reported a two-year overall survival (OS), disease-specific survival (DSS) and disease-free survival (DFS) rates of 59%, 66%, and 56% respectively and five-year OS, DSS, and DFS rates of 42%, 56.5%, and 47%, respectively [ 9 ].…”

“…Results after SS for recurrent oropharyngeal cancer are generally disappointing with survival rates ranging from 13% to 31% at five years [ 9 , 13 , 14 , 17 ]. The anatomy of the oropharynx and its proximity to the skull base leads to difficulties achieving clear margins in advanced recurrent tumors [ 11 ] resulting in low five-year DFS rates of 19–27% [ 9 , 17 ]. In a study from the MD Anderson Cancer Center (Houston), reporting results of salvage treatments in recurrent oropharynx cancer, patients treated with SS had a five-year OS of 28% [ 14 ].…”

“…Hamoir et al have reported that patients with initially advanced stage tumors were six times more likely to develop recurrence compared to patients with Stage I tumors [ 9 ]. Many other authors have reported decreased survival rates in patients with advanced initial tumors because of a higher likelihood of locoregional recurrence and distant metastasis after SS [ 3 , 15 , 16 , 17 , 38 ].…”