Salvage Surgery for Recurrence after Radiotherapy for Squamous Cell Carcinoma of the Head and Neck

Autor: Charlotte L. Zuur, Katarzyna Jóźwiak, Peter J. F. M. Lohuis, Stefan M. Willems, J.P. de Boer, Marcel Verheij, Joris B. W. Elbers, Abrahim Al-Mamgani, Michiel W. M. van den Brekel
Přispěvatelé: MKA AMC (OII, ACTA), CCA - Cancer Treatment and quality of life, Graduate School, Maxillofacial Surgery (AMC)
Rok vydání: 2019
Předmět:
Male
medicine.medical_specialty
salvage surgery
medicine.medical_treatment
Salvage therapy
Head and Neck Neoplasms/mortality
head and neck squamous cell carcinoma
Disease-Free Survival
03 medical and health sciences
Squamous Cell Carcinoma of Head and Neck/mortality
0302 clinical medicine
SDG 3 - Good Health and Well-being
medicine
Journal Article
Humans
030223 otorhinolaryngology
chemoradiation
Survival rate
radiotherapy
Neoplasm Staging
Retrospective Studies
Salvage Therapy
Neoplasm Recurrence
Local/mortality
business.industry
Squamous Cell Carcinoma of Head and Neck
Retrospective cohort study
Local/mortality
Chemoradiotherapy
Middle Aged
medicine.disease
Head and neck squamous-cell carcinoma
Radiation therapy
Survival Rate
Neoplasm Recurrence
Otorhinolaryngology
Head and Neck Neoplasms
030220 oncology & carcinogenesis
Salvage surgery
Surgery
Female
Radiology
Neoplasm Recurrence
Local
business
Rare cancers Radboud Institute for Health Sciences [Radboudumc 9]
Zdroj: Otolaryngology-Head and Neck Surgery, 160, 6, pp. 1023-1033
Otolaryngology-Head and Neck Surgery, 160, 1023-1033
Otolaryngology-Head and Neck Surgery, 160(6), 1023-1033. Mosby Inc.
Otolaryngology and Head and Neck Surgery, 160(6), 1023-1033. Mosby Inc.
Otolaryngology-head and neck surgery, 160(6), 1023-1033. Mosby Inc.
Otolaryngology-Head and Neck Surgery, 160(6), 1023. Mosby Inc.
Elbers, J B W, Al-Mamgani, A, van den Brekel, M W M, Jóźwiak, K, de Boer, J P, Willems, S M, Verheij, M & Zuur, C L 2019, ' Salvage surgery for recurrence after radiotherapy for squamous cell carcinoma of the head and neck ', Otolaryngology-Head and Neck Surgery, vol. 160, no. 6, pp. 1023-1033 . https://doi.org/10.1177/0194599818818443
ISSN: 0194-5998
DOI: 10.1177/0194599818818443
Popis: Item does not contain fulltext OBJECTIVE: Most studies that report on salvage surgery after primary radiotherapy for head and neck squamous cell carcinoma (HNSCC) are small and heterogeneous. Subsequently, some relevant questions remain unanswered. We specifically focused on (1) difference in prognosis per tumor subsite, corrected for disease stage, and (2) differences in prognosis after salvage surgery for local, regional, and locoregional recurrences. STUDY DESIGN: Retrospective analysis. SETTING: Single-center study (2000-2016). SUBJECTS AND METHODS: Patients treated with salvage surgery for HNSCC recurrence after (chemo)radiotherapy. RESULTS: In total, 189 patients were included. Five-year overall survival (OS) was 33%, and median OS was 18 (95% confidence interval [CI], 11-26) months. Treatment-related mortality was 2%. Larynx carcinoma was associated with more favorable local (adjusted hazard ratio [HR] = 4.02; 95% CI, 1.46-11.10; P = .007) and locoregional control (adjusted HR = 5.34; 95% CI, 1.83-15.61; P = .002) than pharyngeal carcinoma. American Society of Anesthesiologists (ASA) score (>/=3 vs 1-2: adjusted HR = 3.04; 95% CI, 1.17-7.91; P = .023), pT stage (3-4 vs 1-2: adjusted HR = 4.41; 95% CI, 1.65-11.82; P = .003), and salvage surgery for locoregional recurrences (locoregional vs local: adjusted HR = 3.81; 95% CI, 1.13-11.82; P = .021) were independent predictors for disease-free survival (DFS). CONCLUSION: Salvage surgery for larynx carcinoma, regardless of disease stage and other prognostic factors, results in more favorable loco(regional) control but not favorable DFS than pharyngeal carcinoma. The observed difference in DFS between salvage surgery for local and regional recurrences was not significant after correction for confounders. However, survival following salvage surgery for locoregional disease is significantly worse. For this subgroup, we propose to consider T status and comorbidity for clinical decision making, as high pT stage and ASA score are independent predictors for worse DFS.
Databáze: OpenAIRE
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