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Outcomes After Oral Cavity and Oropharyngeal Salvage Surgery.
- Source :
-
The Laryngoscope [Laryngoscope] 2022 Oct; Vol. 132 (10), pp. 1984-1992. Date of Electronic Publication: 2022 Feb 22. - Publication Year :
- 2022
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Abstract
- Objectives: Investigate outcomes following oral cavity and oropharyngeal salvage surgery.<br />Methods: Adult patients who underwent salvage surgery for recurrent squamous cell carcinoma of the oral cavity and oropharynx from 1996 to 2018 were analyzed using multivariable Cox proportional hazards regression. Disease-free survival (DFS), overall survival (OS), associated factors, and basic quality measures were analyzed.<br />Results: One hundred and eight patients (72% oral cavity, 28% oropharynx) were followed for a median of 17.9 months. Median DFS and OS were 9.9 and 21 months, respectively. Surgery with adjuvant chemoradiotherapy compared to surgery alone (hazard ratio [HR] = 0.15, 95% confidence interval [CI]: 0.03-0.78) and negative margins (HR = 0.36, 95% CI: 0.14-0.90) were associated with better DFS, while lymphovascular space invasion (LVSI) (HR = 2.66, 95% CI: 1.14-6.19) and higher stage (III vs. I-II, HR = 3.94, 95% CI: 1.22-12.71) were associated with worse DFS. Higher stage was associated with worse OS (HR = 3.79, 95% CI: 1.09-13.19). Patients were hospitalized for a median of 8 days with 24% readmitted within 30 days. A total of 72% and 38% of patients, respectively, underwent placement of a feeding tube or tracheostomy.<br />Conclusions: After oral cavity and oropharyngeal salvage surgery, adjuvant chemoradiotherapy, negative margins, negative LVSI, and lower stage were associated with a lower risk of recurrence. Only lower-stage disease was associated with improved survival. The majority of patients had feeding tubes, half underwent free tissue transfer, a third required tracheostomy, and a quarter was readmitted.<br />Level of Evidence: 3 Laryngoscope, 132:1984-1992, 2022.<br /> (© 2022 The American Laryngological, Rhinological and Otological Society, Inc.)
Details
- Language :
- English
- ISSN :
- 1531-4995
- Volume :
- 132
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- The Laryngoscope
- Publication Type :
- Academic Journal
- Accession number :
- 35191537
- Full Text :
- https://doi.org/10.1002/lary.30070