Salvage surgery after failure of non surgical therapy for advanced head and neck cancer

Introduction: For organ and function preservation, chemoradiotherapy is gaining popularity for primary treatment of advanced head and neck cancer, reserving surgery for salvage.

Methods: Retrospective analysis to determine the results of salvage surgery after failure of primary treatment of advanced head and neck cancer by (chemo)radiotherapy.

Results: Twenty-seven patients with recurrent head and neck cancer tumour were reviewed (larynx n = 13; oral cavity n = 9; hypopharynx n = 5).

The T-stage at initial presentation was T2 in 11 cases and T3 in 16 cases. Patients were staged III in 13 cases and staged IV in 14 patients.

One postoperative death occurred following surgery. The overall incidence of complications was 9/27 (33%). Local recurrence of disease in 25 cases and regional recurrence in 2 cases after a mean follow-up of 11 months (3–136 months).

After the initial salvage treatment, recurrent loco-regional and/or distant disease developed in 10/27 (37%) patients after a mean follow-up of 4 months. 6/10 (60%) of patients died after re-recurrence despite salvage chemotherapy.

Conclusion: Given the morbidity of salvage surgery, and the limited chance for cure, physicians must cautiously counsel patients who are contemplating treatment of recurrent cancer after therapy for advanced disease.

Conflict of interest: None declared.

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Feb 5, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Salvage surgery after failure of non surgical therapy for advanced head and neck cancer
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