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Results of salvage neck dissection after chemoradiation in locally advanced head and neck squamous cell carcinoma

  • Head and Neck
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Abstract

Purpose

Salvage surgery is mandatory when regional persistence/recurrence after chemoradiation. The aim of this study is to describe the outcomes of salvage surgery.

Methods

A retrospective study was conducted in patients with locally advanced head and neck squamous cell carcinoma that were primarily treated with chemorradiation and underwent salvage neck dissection (ND) with suspected recurrent/persistent nodal disease. All patients had a response evaluation at 12 weeks through clinical examination and computed tomography-positron emission tomography. Decision for ND was taken in case of suspected persistence or if there was suspicion of recurrence, histologically confirmed.

Results

There were 40 patients included. 32/40 (80%) ND were done because of confirmed/suspected persistence and 8/40 (20%) were done because of recurrences. Persistence was confirmed histologically in 14/32 (43.8%) cases and recurrence in 6/8 (75%) cases. Median survival from diagnosis was 39 months (95% CI 28.162–49.838). Significant differences were observed between patients who had viable tumour cells in the sample and those who did not, but the differences were only significant when only deaths due to tumour progression were considered (p = 0.014). 14/32 (43.8%) patients with suspected or confirmed persistence developed a recurrence after the ND and 3/8 (37.5%) patients with suspected or confirmed recurrence developed a new recurrence. New recurrences were more frequent in cases that had viable tumor in the specimen.

Conclusions

Patients with nodal persistence/recurrence have a poor prognosis, even after salvage surgery. However, in a substantial number of patients the disease is controlled after ND, so it should be offer to these patients.

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Funding

This study was done without funding.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Hospital Universitario Central de Asturias, Avenida de Roma S/N, 33011, Oviedo, Spain

    L. López, P. García-Cabo, J. L. Llorente, F. López & J. P. Rodrigo

  2. University of Oviedo, Oviedo, Spain

    J. L. Llorente, F. López & J. P. Rodrigo

  3. Department of Head and Neck Oncology, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain

    J. L. Llorente, F. López & J. P. Rodrigo

  4. CIBER de Cáncer, CIBERONC, Madrid, Spain

    J. L. Llorente, F. López & J. P. Rodrigo

Authors
  1. L. López
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  2. P. García-Cabo
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  3. J. L. Llorente
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  4. F. López
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  5. J. P. Rodrigo
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Correspondence to F. López.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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This study was performed in accordance with and approved by the Institutional Ethics Committee of our institution.

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López, L., García-Cabo, P., Llorente, J.L. et al. Results of salvage neck dissection after chemoradiation in locally advanced head and neck squamous cell carcinoma. Eur Arch Otorhinolaryngol 281, 945–951 (2024). https://doi.org/10.1007/s00405-023-08315-z

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  • DOI: https://doi.org/10.1007/s00405-023-08315-z

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