Pei-Hsin Chu1, Ngan-Ming Tsang2,3, Li-Ang Lee1,2, Chun-Ta Liao1,2, Tuan-Jen Fang4,5. 1. Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, 5, Fu-Shin Street, Kweishan 333, Taoyuan, Taiwan. 2. Chang Gung University College of Medicine, Taoyuan, Taiwan. 3. Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan. 4. Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, 5, Fu-Shin Street, Kweishan 333, Taoyuan, Taiwan. fang3109@cgmh.org.tw. 5. Chang Gung University College of Medicine, Taoyuan, Taiwan. fang3109@cgmh.org.tw.
Abstract
PURPOSES: The management of recurrent hypopharyngeal cancer after primary curative-intent radiation or chemoradiation therapy is inconclusive. The benefit of salvage surgery may be reduced by its high complication rate. The improvement of medical care modalities may change the survival after management for loco-reginal recurrences. The present study aims to determine the role of salvage surgery. METHODS: From December 2007 to November 2013, 46 patients with recurrent hypopharyngeal squamous cell carcinoma (HPSCC) after radiation or chemoradiation therapy and without double cancers were recruited. Two year loco-regional failure and overall survival were analyzed and compared between failure patterns. RESULTS: Five-year survival was 24% in patients after loco-regional recurrences. Those who received salvage surgery for loco-regional recurrences had significantly better survival (P < 0.001). Among patients with salvage surgery, 2-year overall survival was significantly higher in recurrent (n = 11) than persistent (n = 24) disease (90 vs 38%, P = 0.006). CONCLUSIONS: Salvage surgery provides better oncologic outcomes in patients with HPSCC, especially for patients with recurrences after 6 months since completion of primary radiation or chemoradiation. The present data of outcomes can be provided for pretreatment consultation for loco-regional recurrent hypopharyngeal cancers.
PURPOSES: The management of recurrent hypopharyngeal cancer after primary curative-intent radiation or chemoradiation therapy is inconclusive. The benefit of salvage surgery may be reduced by its high complication rate. The improvement of medical care modalities may change the survival after management for loco-reginal recurrences. The present study aims to determine the role of salvage surgery. METHODS: From December 2007 to November 2013, 46 patients with recurrent hypopharyngeal squamous cell carcinoma (HPSCC) after radiation or chemoradiation therapy and without double cancers were recruited. Two year loco-regional failure and overall survival were analyzed and compared between failure patterns. RESULTS: Five-year survival was 24% in patients after loco-regional recurrences. Those who received salvage surgery for loco-regional recurrences had significantly better survival (P < 0.001). Among patients with salvage surgery, 2-year overall survival was significantly higher in recurrent (n = 11) than persistent (n = 24) disease (90 vs 38%, P = 0.006). CONCLUSIONS: Salvage surgery provides better oncologic outcomes in patients with HPSCC, especially for patients with recurrences after 6 months since completion of primary radiation or chemoradiation. The present data of outcomes can be provided for pretreatment consultation for loco-regional recurrent hypopharyngeal cancers.