Salvage surgery for recurrent oropharyngeal cancer: post-operative oncologic and functional outcomes

Acta Otolaryngol. 2015;135(12):1323-9. doi: 10.3109/00016489.2015.1066935. Epub 2015 Jul 29.

Abstract

Conclusion: Post-operative outcomes of salvage surgery for recurrent oropharyngeal squamous-cell carcinoma (OPSCC) were acceptable. Pathologic overall, T- or N-stage and patient comorbidities were the main predictors of patient clinical outcomes.

Objectives: To evaluate post-operative outcomes of salvage surgery in patients with recurrent OPSCC and to determine their predictive factors.

Materials and methods: This study retrospectively reviewed the electronic medical records of all patients who underwent salvage surgery for recurrent OPSCC, between 2000-2013, in our institution. Overall survival (OS) and cause-specific survival (SS) were determined by Kaplan-Meier analysis. Predictive factors of post-operative outcomes were investigated by using univariate and multivariate analyses.

Results: A total of 34 patients were included in this study. Local and general post-operative complication rates were 26% and 27%, respectively. A high level of comorbidity (Kaplan Feinstein Index: KFI ≥ 2) was the only factor associated with a higher risk of local (p = 0.03) and general (p = 0.04) complications. OS and SS rates at 3 years were 48% and 61%, respectively. In multivariate analysis, pathologic overall stage ≥ III was a significant predictor of OS (p = 0.02) and pathologic T-stage ≥ 3 was a significant predictor of SS (p = 0.01). Mean pre-operative and post-operative DOSS (dysphagia outcome and severity scale) scores were 4.4 and 3.9, respectively.

Keywords: head and neck cancer; oropharynx; radiotherapy; recurrence; salvage surgery; squamous cell carcinoma.

MeSH terms

  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / therapy*
  • Disease-Free Survival
  • Female
  • France / epidemiology
  • Humans
  • Kaplan-Meier Estimate
  • Laryngectomy / methods
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / therapy*
  • Oropharyngeal Neoplasms / diagnosis
  • Oropharyngeal Neoplasms / mortality
  • Oropharyngeal Neoplasms / therapy*
  • Prognosis
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Salvage Therapy / methods*
  • Survival Rate / trends
  • Treatment Outcome