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The role of salvage surgery in patients with recurrent squamous cell carcinoma of the oropharynx
Cancer, 09/23/09

Zafereo ME et al. – Age, disease-free interval, recurrent tumor stage, recurrent neck disease, and surgical margin status influenced overall survival or recurrence rate after salvage surgery for recurrent SCCOP. Although most patients had good functional outcomes, only a select group of patients with recurrent SCCOP achieved long-term survival after salvage surgery.

Methods

1681 consecutive patients who completed definitive therapy for primary SCCOP and identified 168 patients with locally recurrent SCCOP who underwent salvage surgery (41 patients), reirradiation or brachytherapy (18 patients), palliative chemotherapy (70 patients), or supportive care (39 patients)

Results

26 of 39 patients (67%) developed a second recurrence after salvage surgery
3-year overall survival rate for patients who underwent salvage surgery or received reirradiation, palliative chemotherapy, or supportive care were 48.7%, 31.6%, 3.7%, and 5.1%, respectively
For patients who underwent salvage surgery, older age, the absence of a disease-free interval, and advanced recurrent tumor stage were associated with lower overall survival
Patients with recurrent neck disease and positive surgical margins had higher rates of recurrence after salvage surgery
Postoperative complications occurred in 19 patients (46%), and there were no perioperative deaths
Functionally, 71% of patients demonstrated 80% speech intelligibility, 68% were able to tolerate some oral intake, and 87% who required a tracheotomy subsequently were decannulated

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