Surgical and functional outcomes after salvage oropharyngectomy.

Autor: Balaguru L; Department of Otolaryngology, University of Florida, Gainesville, FL, USA. Electronic address: lbalaguru@ufl.edu., Hanubal KS; University of Florida College of Medicine, Gainesville, FL, USA., Galochkina Z; Department of Biostatistics, University of Florida, Gainesville, FL, USA., Lee JH; Department of Biostatistics, University of Florida, Gainesville, FL, USA., Chow L; Department of Otolaryngology, University of Florida, Gainesville, FL, USA., Conrad D; Department of Otolaryngology, University of Florida, Gainesville, FL, USA; University of Florida Health Cancer Center, Gainesville, FL, USA., Dziegielewski PT; Department of Otolaryngology, University of Florida, Gainesville, FL, USA; University of Florida Health Cancer Center, Gainesville, FL, USA.
Jazyk: angličtina
Zdroj: Oral oncology [Oral Oncol] 2024 Dec; Vol. 159, pp. 107050. Date of Electronic Publication: 2024 Oct 03.
DOI: 10.1016/j.oraloncology.2024.107050
Abstrakt: Objectives: Salvage oropharyngeal surgery with free-flap reconstruction after failed radiation therapy (RT) presents unique challenges and complications. The aim of this retrospective review is to examine surgical complications and functional outcomes in patients who received salvage surgery for recurrent or persistent oropharyngeal cancer following RT.
Patients and Methods: Patients diagnosed with oropharyngeal cancer and underwent salvage oropharyngectomy at the University of Florida between 2016-2021 were identified from inpatient and outpatient records of the Head and Neck Oncology Team. Outcomes measured were tracheostomy dependence, tube-feed dependence, and intact oral intake status. Survival outcomes using Kaplan-Meier product limit method were calculated.
Results and Conclusion: Twenty-six patients were included in the analysis. Average age was 63.7 years. Fourteen (53.8 %) oropharyngectomies used a transmandibular approach, ten (38.5 %) through a combined transoral and transcervical approach, and two (7.7 %) through a transcervical approach. Average time to tracheostomy decannulation was 25.1 days. At 6 months, twenty (83.3 %) patients were gastric tube independent with twelve (54.2 %) patients tolerating any oral intake. At 12 months, gastric tube independent feeds decreased to nine (60 %) patients with thirteen (92.9 %) patients tolerating oral intake. The median overall survival was 27 months with local cancer recurrence being the most common cause of death. Patients undergoing salvage oropharyngectomy for recurrent disease continue to face prolonged tracheostomy and tube dependent feedings. Despite intact swallowing function, patients preferred to use gastric tube feedings, likely for speed, ease, and convenience. Further studies are needed to analyze factors influencing these conflicting functional outcomes and predictive factors impacting survival.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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