Outcomes After Oral Cavity and Oropharyngeal Salvage Surgery
Title
Outcomes After Oral Cavity and Oropharyngeal Salvage Surgery
Creator
Bhavya K Sharma
Kevin J Contrera
Xuefei Jia
Christopher Fleming
Robert R Lorenz
Shlomo A Koyfman
Chengetai Mahomva
Khashayar Arianpour
Brian B Burkey
Michael Fritz
Jamie A Ku
Eric D Lamarre
Joseph Scharpf
Brandon L Prendes
Date
2022
Description
Objectives: Investigate outcomes following oral cavity and oropharyngeal salvage surgery.
Methods: Adult patients who underwent salvage surgery for recurrent squamous cell carcinoma of the oral cavity and oropharynx from 1996 to 2018 were analyzed using multivariable Cox proportional hazards regression. Disease-free survival (DFS), overall survival (OS), associated factors, and basic quality measures were analyzed.
Results: One hundred and eight patients (72% oral cavity, 28% oropharynx) were followed for a median of 17.9 months. Median DFS and OS were 9.9 and 21 months, respectively. Surgery with adjuvant chemoradiotherapy compared to surgery alone (hazard ratio [HR] = 0.15, 95% confidence interval [CI]: 0.03-0.78) and negative margins (HR = 0.36, 95% CI: 0.14-0.90) were associated with better DFS, while lymphovascular space invasion (LVSI) (HR = 2.66, 95% CI: 1.14-6.19) and higher stage (III vs. I-II, HR = 3.94, 95% CI: 1.22-12.71) were associated with worse DFS. Higher stage was associated with worse OS (HR = 3.79, 95% CI: 1.09-13.19). Patients were hospitalized for a median of 8 days with 24% readmitted within 30 days. A total of 72% and 38% of patients, respectively, underwent placement of a feeding tube or tracheostomy.
Conclusions: After oral cavity and oropharyngeal salvage surgery, adjuvant chemoradiotherapy, negative margins, negative LVSI, and lower stage were associated with a lower risk of recurrence. Only lower-stage disease was associated with improved survival. The majority of patients had feeding tubes, half underwent free tissue transfer, a third required tracheostomy, and a quarter was readmitted.
Level of evidence: 3 Laryngoscope, 132:1984-1992, 2022.
Methods: Adult patients who underwent salvage surgery for recurrent squamous cell carcinoma of the oral cavity and oropharynx from 1996 to 2018 were analyzed using multivariable Cox proportional hazards regression. Disease-free survival (DFS), overall survival (OS), associated factors, and basic quality measures were analyzed.
Results: One hundred and eight patients (72% oral cavity, 28% oropharynx) were followed for a median of 17.9 months. Median DFS and OS were 9.9 and 21 months, respectively. Surgery with adjuvant chemoradiotherapy compared to surgery alone (hazard ratio [HR] = 0.15, 95% confidence interval [CI]: 0.03-0.78) and negative margins (HR = 0.36, 95% CI: 0.14-0.90) were associated with better DFS, while lymphovascular space invasion (LVSI) (HR = 2.66, 95% CI: 1.14-6.19) and higher stage (III vs. I-II, HR = 3.94, 95% CI: 1.22-12.71) were associated with worse DFS. Higher stage was associated with worse OS (HR = 3.79, 95% CI: 1.09-13.19). Patients were hospitalized for a median of 8 days with 24% readmitted within 30 days. A total of 72% and 38% of patients, respectively, underwent placement of a feeding tube or tracheostomy.
Conclusions: After oral cavity and oropharyngeal salvage surgery, adjuvant chemoradiotherapy, negative margins, negative LVSI, and lower stage were associated with a lower risk of recurrence. Only lower-stage disease was associated with improved survival. The majority of patients had feeding tubes, half underwent free tissue transfer, a third required tracheostomy, and a quarter was readmitted.
Level of evidence: 3 Laryngoscope, 132:1984-1992, 2022.
Source
Laryngoscope
. 2022 Oct;132(10):1984-1992. doi: 10.1002/lary.30070. Epub 2022 Feb 22.
. 2022 Oct;132(10):1984-1992. doi: 10.1002/lary.30070. Epub 2022 Feb 22.
Language
English
URL
https://doi.org/10.1002/lary.30070
Citation
Bhavya K Sharma et al., “Outcomes After Oral Cavity and Oropharyngeal Salvage Surgery,” NEOMED Bibliography Database, accessed April 23, 2024, https://neomed.omeka.net/items/show/12014.