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Functional and quality-of-life outcomes following salvage surgery for recurrent squamous cell carcinoma of the head and neck: a systematic review and meta-analysis

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Abstract

Background

Recurrent head and neck squamous cell carcinomas (HNSCC) are frequently managed with salvage surgery, but the impact these operations have on function and quality-of-life (QoL) is understudied. This review aimed to provide a quantitative and qualitative assessment of the functional and QoL effects of salvage surgical procedures.

Methods

Systematic review and meta-analysis were conducted of studies reporting QoL and function following salvage HNSCC resections.

Results

The search identified 415 articles and 34 were selected for inclusion. Pooled random effects analysis revealed long-term feeding and tracheostomy tube rates of 18% and 7%. Pooled long-term feeding tube rates in open oral and oropharyngeal, transoral robotic, total and partial laryngectomy surgeries were 41%, 25%, 11% and 4%. Eight studies used validated QoL questionnaires.

Conclusions

Functional and QoL outcomes from salvage surgery are acceptable, but appear to be worse following open procedures. Prospective studies measuring changes over time are needed to assess these procedures impact on patient well-being.

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Data availability

Data sharing is not applicable to this article as no new data were created or analysed in this study.

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Acknowledgements

We would like to thank the entire team at the International Centre for Recurrent Head and Neck Cancer and the Royal Marsden Head and Neck Clinical trials unit for their ongoing support with this article and our wider programme of research.

Funding

The salaries for clinical research fellows (AW and FJA) are provided by a grant from the Royal Marsden Cancer charity. This article did not receive any specific funding from research or for-profit sectors.

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Authors and Affiliations

  1. International Centre for Recurrent Head and Neck Cancer (IReC), Department of Head and Neck Surgery, The Royal Marsden Hospital, London, UK

    Andrew Williamson, Farizeh Jashek-Ahmed, John Hardman & Vinidh Paleri

  2. Institute for Cancer Research, London, UK

    Andrew Williamson, John Hardman & Vinidh Paleri

  3. London School of Hygiene and Tropical Medicine, London, UK

    Farizeh Jashek-Ahmed

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Williamson, A., Jashek-Ahmed, F., Hardman, J. et al. Functional and quality-of-life outcomes following salvage surgery for recurrent squamous cell carcinoma of the head and neck: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 280, 4597–4618 (2023). https://doi.org/10.1007/s00405-023-08056-z

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