OBJECTIVES/HYPOTHESIS: To evaluate outcomes of salvage surgery with free flap reconstruction for recurrent squamous cell carcinoma of the oropharynx and oral cavity with increased use of chemoradiotherapy. STUDY DESIGN: Retrospective patient review. METHODS: All patients undergoing salvage surgery with free flap reconstruction for oropharynx (n = 36) and oral cavity (n = 36) squamous cell carcinomas between January 2001 and January 2008 were obtained. Mean follow-up was 14 months. Previous chemoradiotherapy was used in 40% and radiotherapy alone in 60%. RESULTS: Complications were more frequent in oropharynx than oral cavity tumors (36% and 14%, respectively; P = .05) requiring more secondary procedures (15 for oropharynx vs. six for oral cavity). Few patients returned to a normal diet (8%), and a majority retained an enterogastric feeding tube (56%). Median survival overall following salvage surgery was 44.8 months for oral cavity and 53.8 months for oropharynx head and neck squamous cell carcinoma. Overall estimated 1-, 2-, and 5-year observed survivals were 98%, 77.2%, and 43.7%, respectively. Twelve patients had a disease-free interval of <6 months, 92% of whom died of disease. Of 17 patients with disease at the primary site and involved regional lymph nodes, 94% died of disease. CONCLUSIONS: Salvage surgery with free flap reconstruction for recurrent oral and oropharyngeal tumors after chemoradiotherapy has acceptable morbidity and similar cure rates as salvage following radiotherapy without chemotherapy. Concurrent nodal recurrence and short disease-free interval are associated with reduced cure rates. A significant proportion will require enterogastric feeding and few will tolerate a normal diet.
OBJECTIVES/HYPOTHESIS: To evaluate outcomes of salvage surgery with free flap reconstruction for recurrent squamous cell carcinoma of the oropharynx and oral cavity with increased use of chemoradiotherapy. STUDY DESIGN: Retrospective patient review. METHODS: All patients undergoing salvage surgery with free flap reconstruction for oropharynx (n = 36) and oral cavity (n = 36) squamous cell carcinomas between January 2001 and January 2008 were obtained. Mean follow-up was 14 months. Previous chemoradiotherapy was used in 40% and radiotherapy alone in 60%. RESULTS: Complications were more frequent in oropharynx than oral cavity tumors (36% and 14%, respectively; P = .05) requiring more secondary procedures (15 for oropharynx vs. six for oral cavity). Few patients returned to a normal diet (8%), and a majority retained an enterogastric feeding tube (56%). Median survival overall following salvage surgery was 44.8 months for oral cavity and 53.8 months for oropharynx head and neck squamous cell carcinoma. Overall estimated 1-, 2-, and 5-year observed survivals were 98%, 77.2%, and 43.7%, respectively. Twelve patients had a disease-free interval of <6 months, 92% of whom died of disease. Of 17 patients with disease at the primary site and involved regional lymph nodes, 94% died of disease. CONCLUSIONS: Salvage surgery with free flap reconstruction for recurrent oral and oropharyngeal tumors after chemoradiotherapy has acceptable morbidity and similar cure rates as salvage following radiotherapy without chemotherapy. Concurrent nodal recurrence and short disease-free interval are associated with reduced cure rates. A significant proportion will require enterogastric feeding and few will tolerate a normal diet.
Authors: Arlene A Forastiere; Helmuth Goepfert; Moshe Maor; Thomas F Pajak; Randal Weber; William Morrison; Bonnie Glisson; Andy Trotti; John A Ridge; Clifford Chao; Glen Peters; Ding-Jen Lee; Andrea Leaf; John Ensley; Jay Cooper Journal: N Engl J Med Date: 2003-11-27 Impact factor: 91.245
Authors: Rajeev Sharan; Subramania Iyer; Shilpa S Chatni; Jacob Samuel; Karimassery R Sundaram; Richard F Cohen; Keechilat Pavithran; Moni Abraham Kuriakose Journal: Head Neck Date: 2008-11 Impact factor: 3.147
Authors: Luke M Richey; Carol G Shores; Jonathan George; Steve Lee; Marion J Couch; David K Sutton; Mark C Weissler Journal: Otolaryngol Head Neck Surg Date: 2007-01 Impact factor: 3.497
Authors: Ivan Marcelo Gonçalves Agra; André Lopes Carvalho; Fábio Samsonovski Ulbrich; Olímpio Daniel de Campos; Everton Pontes Martins; José Magrin; Luiz Paulo Kowalski Journal: Head Neck Date: 2006-02 Impact factor: 3.147
Authors: Sharon A Spencer; Jonathan Harris; Richard H Wheeler; Mitchell Machtay; Christopher Schultz; William Spanos; Marvin Rotman; Ruby Meredith; Kie-Kian Ang Journal: Head Neck Date: 2008-03 Impact factor: 3.147
Authors: Kirk P Withrow; Eben L Rosenthal; Christine G Gourin; Glenn E Peters; J Scott Magnuson; David J Terris; William W Carroll Journal: Laryngoscope Date: 2007-05 Impact factor: 3.325
Authors: Theresa Guo; Jesse R Qualliotine; Patrick K Ha; Joseph A Califano; Young Kim; John R Saunders; Ray G Blanco; Gypsyamber D'Souza; Zhe Zhang; Christine H Chung; Ana Kiess; Christine G Gourin; Wayne Koch; Jeremy D Richmon; Nishant Agrawal; David W Eisele; Carole Fakhry Journal: Cancer Date: 2015-03-17 Impact factor: 6.860
Authors: Allen S Ho; Zachary S Zumsteg; Annika Meyer; Nadeem Riaz; Rahmatullah Rahmati; Dennis H Kraus; Colleen McCarthy; Richard J Wong; Jatin P Shah; Nancy Y Lee Journal: Ann Surg Oncol Date: 2016-08-09 Impact factor: 5.344
Authors: Carole Fakhry; Jesse R Qualliotine; Zhe Zhang; Nishant Agrawal; Daria A Gaykalova; Justin A Bishop; Rathan M Subramaniam; Wayne M Koch; Christine H Chung; David W Eisele; Joseph Califano; Raphael P Viscidi Journal: Cancer Prev Res (Phila) Date: 2015-12-23
Authors: Sylvia L Crowder; Andrew D Frugé; Katherine G Douglas; Yi Tang Chen; Laura Moody; Ashley Delk-Licata; John W Erdman; Molly Black; William R Carroll; Sharon A Spencer; Julie L Locher; Wendy Demark-Wahnefried; Laura Q Rogers; Anna E Arthur Journal: J Acad Nutr Diet Date: 2019-01-17 Impact factor: 4.910