Salvage surgery for local residual or recurrent pharyngeal cancer after radiotherapy or chemoradiotherapy

Go Omura, Yuki Saito, Mizuo Ando, Kenya Kobayashi, Yasuhiro Ebihara, Tatsuya Yamasoba, Takahiro Asakage

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)

Abstract

Objectives/Hypothesis Local residual or recurrent pharyngeal cancer after definitive radiotherapy (RT) or chemoradiotherapy (CRT) is correlated to poor prognosis. We analyzed the efficacy of salvage surgery for patients with local residual or recurrent pharyngeal cancer after RT or CRT. Study Design Retrospective clinical study with chart review. Methods Between 2001 and 2011, we treated 207 patients with resectable pharyngeal cancer, including 98 patients with oropharyngeal cancer (OPC) and 109 patients with hypopharyngeal cancer (HPC) who received definitive RT or CRT. Local residual or recurrence developed in 59 patients (23 with OPC; 36 with HPC), of whom 42 (18 with OPC; 24 with HPC) underwent salvage surgery. These 42 patients were investigated in this study. Results The initial treatments were RT; RT with induction chemotherapy (IC); and concurrent CRT in 12, 9, and 21 patients, respectively. The median radiation dose was 70 Gy. The 3-year disease-specific survival rate after salvage surgery was 40% (median, 26 months). The significant prognostic factors were stage IV prior to initial therapy (P = .049), development of concurrent local and regional relapse (P = .02), and OPC (P = .04). Conclusions The efficacy of salvage surgery for local residual or recurrent pharyngeal cancer was limited. Oropharynx origin, stage IV prior to initial therapy, and concurrent regional relapses were significantly poor prognostic factors. Salvage surgery for HPC is worth challenging aggressively. Conversely, the indication of salvage surgery for OPCs should be carefully considered because of its low cure rate. Level of Evidence 4.

Original languageEnglish
Pages (from-to)2075-2080
Number of pages6
JournalLaryngoscope
Volume124
Issue number9
DOIs
Publication statusPublished - Sep 2014
Externally publishedYes

Keywords

  • definitive radiotherapy or chemoradiotherapy
  • local residual and recurrence
  • Pharyngeal cancer
  • salvage surgery

ASJC Scopus subject areas

  • Otorhinolaryngology

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