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Management of recurrent head and neck cancer: variables related to salvage surgery

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Abstract

After a local and/or regional recurrence of head and neck squamous cell carcinoma (HNSCC) not all patients are candidates to salvage treatment. The objective of this study was to identify the variables related to performance of salvage surgery with curative intent in these patients. We performed a retrospective study of 1088 HNSCC patients with a local and/or regional recurrence. According to a multivariate analysis, the variables related to performance of salvage surgery were the Karnofsky index, the location and extension of the primary tumor, the initial treatment, the disease-free interval between treatment of the initial tumor and diagnosis of the recurrence, and the year the recurrence was diagnosed. Considering salvage surgery as the dependent variable, the results of a recursive partitioning analysis defined four categories of patients in function of the category of local and regional extension of the initial tumor, the location of the primary tumor, the initial treatment and the disease-free interval between treatment of the initial tumor and diagnosis of the recurrence.

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References

  1. Goodwin WJ Jr (2000) Salvage surgery for patients with recurrent squamous cell carcinoma of the upper aerodigestive tract: when do the ends justify the means? Laryngoscope 110(2 Suppl 93):1–18

    Article  PubMed  Google Scholar 

  2. Ho AS, Kraus DH, Ganly I, Lee NY, Shah JP, Morris LG (2014) Decision making in the management of recurrent head and neck cancer. Head Neck 36:144–151

    Article  PubMed  Google Scholar 

  3. Rodrigo JP, Kowalski LP, Silver CE, de Bree R, Rinaldo A, Shaha AR, Strojan P, Elsheikh MN, Haigentz M Jr, Sanabria A, Coskun HH, Takes RP, Ferlito A (2015) When is reoperative surgery not indicated for recurrent head and neck squamous cell carcinoma? Eur Arch Otorhinolaryngol 272:259–262

    Article  PubMed  Google Scholar 

  4. Kim J, Kim S, Albergotti WG, Choi PA, Kaplan DJ, Abberbock S, Johnson JT, Gildener-Leapman N (2015) Selection of ideal candidates for surgical salvage of head and neck squamous cell carcinoma: effect of the Charlson-age comorbidity index and oncologic characteristics on 1-year survival and hospital course. JAMA Otolaryngol Head Neck Surg 141:1059–1065

    Article  PubMed  Google Scholar 

  5. León X, Orús C, Quer M (2002) Design, maintenance, and exploitation of an oncologic database for patients with malignant tumors of the head and neck. Acta Otorrinolaringol Esp 53:185–190

    Article  PubMed  Google Scholar 

  6. Parsons JT, Mendenhall WM, Stringer SP, Cassisi NJ, Million RR (1995) Salvage surgery following radiation failure in squamous cell carcinoma of the supraglottic larynx. Int J Radiat Oncol Biol Phys 32:605–609

    Article  CAS  PubMed  Google Scholar 

  7. Stoeckli SJ, Pawlik AB, Lipp M, Huber A, Schmid S (2000) Salvage surgery after failure of nonsurgical therapy for carcinoma of the larynx and hypopharynx. Arch Otolaryngol Head Neck Surg 126:1473–1477

    Article  CAS  PubMed  Google Scholar 

  8. Johansen LV, Grau C, Overgaard J (2002) Supraglottic carcinoma: patterns of failure and salvage treatment after curatively intended radiotherapy in 410 consecutive patients. Int J Radiat Oncol Biol Phys 53:948–958

    Article  PubMed  Google Scholar 

  9. Johansen LV, Grau C, Overgaard J (2002) Glottic carcinoma—patterns of failure and salvage treatment after curative radiotherapy in 861 consecutive patients. Radiother Oncol 63:257–267

    Article  PubMed  Google Scholar 

  10. Wong LY, Wei WI, Lam LK, Yuen AP (2003) Salvage of recurrent head and neck squamous cell carcinoma after primary curative surgery. Head Neck 25:953–959

    Article  PubMed  Google Scholar 

  11. Taussky D, Dulguerov P, Allal AS (2005) Salvage surgery after radical accelerated radiotherapy with concomitant boost technique for head and neck carcinomas. Head Neck 27:182–186

    Article  PubMed  Google Scholar 

  12. Temam S, Pape E, Janot F, Wibault P, Julieron M, Lusinchi A, Mamelle G, Marandas P, Luboinski B, Bourhis J (2005) Salvage surgery after failure of very accelerated radiotherapy in advanced head-and-neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys 62:1078–1083

    Article  PubMed  Google Scholar 

  13. Ord RA, Kolokythas A, Reynolds MA (2006) Surgical salvage for local and regional recurrence in oral cancer. J Oral Maxillofac Surg 64:1409–1414

    Article  PubMed  Google Scholar 

  14. Liao CT, Chang JT, Wang HM, Ng SH, Hsueh C, Lee LY, Lin CH, Chen IH, Huang SF, Cheng AJ, Yen TC (2008) Salvage therapy in relapsed squamous cell carcinoma of the oral cavity: how and when? Cancer 112:94–103

    Article  PubMed  Google Scholar 

  15. Agrawal A, Hammond TH, Young GS, Avon AL, Ozer E, Schuller DE (2009) Factors affecting long-term survival in patients with recurrent head and neck cancer may help define the role of post-treatment surveillance. Laryngoscope 119:2135–2140

    Article  PubMed  Google Scholar 

  16. Zafereo ME, Hanasono MM, Rosenthal DI, Sturgis EM, Lewin JS, Roberts DB, Weber RS (2009) The role of salvage surgery in patients with recurrent squamous cell carcinoma of the oropharynx. Cancer 115:5723–5733

    Article  PubMed  Google Scholar 

  17. Röösli C, Studer G, Stoeckli SJ (2010) Salvage treatment for recurrent oropharyngeal squamous cell carcinoma. Head Neck 32:989–996

    Article  PubMed  Google Scholar 

  18. Bachar GY, Goh C, Goldstein DP, O’Sullivan B, Irish JC (2010) Long-term outcome analysis after surgical salvage for recurrent tonsil carcinoma following radical radiotherapy. Eur Arch Otorhinolaryngol 267:295–301

    Article  PubMed  Google Scholar 

  19. Tan HK, Giger R, Auperin A, Bourhis J, Janot F, Temam S (2010) Salvage surgery after concomitant chemoradiation in head and neck squamous cell carcinomas—stratification for postsalvage survival. Head Neck 32:139–147

    Article  CAS  PubMed  Google Scholar 

  20. Nichols AC, Kneuertz PJ, Deschler DG, Lin DT, Emerick KS, Clark JR, Busse PW, Rocco JW (2011) Surgical salvage of the oropharynx after failure of organ-sparing therapy. Head Neck 33:516–524

    Article  PubMed  Google Scholar 

  21. Kano S, Homma A, Hayashi R, Kawabata K, Yoshino K, Iwae S, Hasegawa Y, Nibu K, Kato T, Shiga K, Matsuura K, Monden N, Fujii M (2013) Salvage surgery for recurrent oropharyngeal cancer after chemoradiotherapy. Int J Clin Oncol 18:817–823

    Article  CAS  PubMed  Google Scholar 

  22. Mücke T, Wagenpfeil S, Kesting MR, Hölzle F, Wolff KD (2009) Recurrence interval affects survival after local relapse of oral cancer. Oral Oncol 45:687–691

    Article  PubMed  Google Scholar 

  23. Virós Porcuna D, León Vintró X, López Vilas M, Pujol Olmo A, Masià Ayala J, Quer Agustí M (2008) Pectoralis major flaps. Evolution of their use in the age of microvascularized flaps. Acta Otorrinolaringol Esp 59:263–268

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Otorhinolaryngology Department, Hospital Nostra Senyora de Meritxell, Andorra La Vella, Andorra

    Laura Gañán

  2. Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, c/Mas Casanovas, 90, 08041, Barcelona, Spain

    Montserrat López, Jacinto García, Miquel Quer & Xavier León

  3. Otorhinolaryngology Department, Hospital General de Catalunya, Universitat Internacional de Catalunya, San Cugat del Vallès, Barcelona, Spain

    Eduard Esteller

  4. Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain

    Xavier León

Authors
  1. Laura Gañán
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  2. Montserrat López
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  3. Jacinto García
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  4. Eduard Esteller
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  5. Miquel Quer
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  6. Xavier León
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Corresponding author

Correspondence to Xavier León.

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Funding

This study was supported by a grant from Instituto de Salud Carlos III (FIS 14-01819).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Due to the retrospective type of the study no formal consent was required.

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Gañán, L., López, M., García, J. et al. Management of recurrent head and neck cancer: variables related to salvage surgery. Eur Arch Otorhinolaryngol 273, 4417–4424 (2016). https://doi.org/10.1007/s00405-016-4093-3

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  • DOI: https://doi.org/10.1007/s00405-016-4093-3

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