Salvage treatment for recurrent oropharyngeal squamous cell carcinoma

Röösli, Christof; Studer, Gabriela; Stoeckli, Sandro J.

doi:10.1002/hed.21273

Cited by 34 publications

(27 citation statements)

References 36 publications

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“…For the secondary analysis in which recurrence was detected following the second posttherapeutic FDG-PET at nine months, the majority of patients (22/40 (55.0%)) qualified for salvage surgery, meaning that the strategy of close follow-up with imaging is valuable. This rate compares favorably with salvage eligibility rates reported by other studies (23% to 38%) 23,[33][34][35] . This finding, however, has to be interpreted with caution as eligibility for salvage surgery strongly depends on the primary tumor site, with the larynx being the site most often eligible for salvage surgery 26 .…”

Section: Discussionsupporting

confidence: 78%

Predictive value of suvmax changes between two sequential post-therapeutic FDG-pet in head and neck squamous cell carcinomas

Stadler

Hüllner

Broglie

et al. 2020

Sci Rep

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18-flurodesoxyglucose position emission tomography (FDG-PET) with computed tomography (CT) or magnetic resonance imaging (MRI) is a broadly accepted tool for pretherapeutic staging and post-therapeutic assessment of response. The prognostic value of sequential post-therapeutic FDG-PETs and the impact of change in metabolic activity has been scarcely reported so far. We hypothesized that an increase in metabolic activity (as measured by maximum standardized uptake value, SUVmax) would be predictive for recurrence. We retrospectively assessed all oral, oropharyngeal, laryngeal, and hypopharyngeal squamous cell carcinoma patients treated at the Department of Otorhinolaryngology—Head and Neck Surgery, University Hospital Zurich between April 1st, 2010 and September 30th, 2018 (N = 337). After a negative post-treatment FDG-PET at 3 months, we measured the SUVmax of the local tumor area and the regional lymph nodes on follow-up FDG-PET at 9 months. We then correlated SUVmax difference between 9 and 3 months with tumor recurrence using Kaplan Meier analysis. During follow-up, 68 patients (20.2%) had local recurrence and 53 had regional recurrence (15.7%) at a median time of 9.0 (IQR 4.25–14) and 7.0 (IQR 5.25–23) months, respectively. An increase in local and/or regional SUVmax from the 3 months to the 9 months post-therapeutic FDG-PET resulted in a poorer recurrence-free survival (Log rank, P = 0.001, for both). An increase in local SUVmax between 3 and 9 months was associated with a hazard ratio of 4.17 for recurrence (95%CI 1.89–9.2, P = 0.0003). In conclusion, an increase in metabolic activity/SUVmax between two post-therapeutic FDG-PETs requires a histological examination as it is associated with tumor recurrence.

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Section: Discussionsupporting

confidence: 78%

Predictive value of suvmax changes between two sequential post-therapeutic FDG-pet in head and neck squamous cell carcinomas

Stadler

Hüllner

Broglie

et al. 2020

Sci Rep

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“…These patients had unresectable persistent disease and/or were not amenable to RT. Additional factors favoring BSC instead of second-line treatment were age over 80 years, severe comorbidity, and high initial UICC stage, frequently in combination [ 14 , 15 , 16 ] ( Table 3 ). However, individual patient or disease factors which are difficult to classify and record, such as clinical impression of treating physicians, may also have influenced ITB decisions.…”

Section: Discussionmentioning

confidence: 99%

Persistent Head and Neck Cancer Following First-Line Treatment

Steinbichler

Lichtenecker

Anegg

et al. 2018

Cancers

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Background: Following first-line treatment of head and neck cancer (HNC), persistent disease may require second-line treatment. Methods: All patients with HNC treated between 2008 and 2016 were included. Second-line treatment modalities and survival of patients were analyzed. Results: After first-line therapy, 175/741 patients had persistent disease. Of these, 112 were considered eligible for second-line treatment. Second-line treatment resulted in 50% complete response. Median overall survival of patients receiving second-line therapy was 24 (95% CI: 19 to 29) months; otherwise survival was 10 (9 to 11; p < 0.0001) months. Patients receiving second-line surgery had a median overall survival of 45 (28 to 62) months, patients receiving second-line radiotherapy had a median overall survival of 37 (0 to 79; p = 0.17) months, and patients receiving systemic therapy had a median overall survival of 13 (10 to 16; p < 0.001) months. Patients with persistent HNC in the neck had a better median survival (45 months; 16 to 74 months; p = 0.001) than patients with persistence at other sites. Conclusion: Early treatment response evaluation allows early initiation of second-line treatment and offers selected patients with persistent disease a realistic chance to achieve complete response after all. If possible, surgery or radiotherapy are preferable.

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“…Local failure after radiotherapy or chemoradiotherapy still occurs in a subset of patients regardless of HPV status. The preferred modality of treatment in these cases is salvage surgery …”

Section: Introductionmentioning

confidence: 99%

Salvage surgery for locally recurrent oropharyngeal cancer

et al. 2015

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Surgical salvage for oropharyngeal SCC after failure of radiotherapy (+/- chemotherapy) is feasible. Patients who may benefit from surgery include those without regional recurrence and/or those in whom negative margins can be obtained. However, patients may be tracheotomy or gastrostomy tube dependent. The p16 status did not seem to have prognostic impact in the salvage setting; however, larger series are required to assess this relationship. © 2015 Wiley Periodicals, Inc. Head Neck 38: E658-E664, 2016.

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Salvage treatment for recurrent oropharyngeal squamous cell carcinoma

Abstract: Patients with an advanced OPSCC have a considerable risk for recurrence. Despite poor ultimate outcome, salvage treatment should be attempted in patients with resectable disease, good performance status, and absence of distant metastases.

Cited by 34 publications

References 36 publications

Predictive value of suvmax changes between two sequential post-therapeutic FDG-pet in head and neck squamous cell carcinomas

Predictive value of suvmax changes between two sequential post-therapeutic FDG-pet in head and neck squamous cell carcinomas

Persistent Head and Neck Cancer Following First-Line Treatment

Salvage surgery for locally recurrent oropharyngeal cancer

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