Predictive factors for successful head and neck salvage surgery

Introduction In the case of recurrent squamous cell carcinoma of the head and neck after radiation, salvage surgery is often the last remaining curative treatment option. Patient selection for these overly complex and risky procedures remains challenging. This study analyzes the outcomes and survival rates of patients that received salvage surgery at the University Hospital Dresden to identify predictive factors for high long-term survival and a good functional outcome.

Material and methods In a retrospective cohort study we analyzed patients with a history of head and neck radiation who presented with recurrent disease requiring salvage surgery between 2013 and 2023 (n=37). In the process the patients " characteristics, the carcinogens, especially the therapeutic effort (length of hospital stay, surgery time, numbers of revision), the functional outcome and possible predictors were evaluated. The patients were also classified into a modified three-class stratification system based on prior studies, consisting of factors like the primary surgical care, the duration of the recurrence-free period after radiation and dependence on feeding tubes or tracheostomy.

Results The median survival time between primary and recurrent tumor was 456 days. Long-term survival after salvage surgery was 35 months. The three-class stratification system can estimate the patient's expected survival time.

Conclusion The selection of suitable patients is crucial as salvage surgeries can extend patients" lives by several years, but are usually accompanied with a high treatment-related morbidity.

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Artikel online veröffentlicht:
19. April 2024