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International Journal of Clinical Oncology

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01-10-2016 | Original Article

Treatment results and prognostic factors for advanced squamous cell carcinoma of the head and neck treated with salvage surgery after concurrent chemoradiotherapy

Authors: Takahide Taguchi, Goshi Nishimura, Masahiro Takahashi, Osamu Shiono, Masanori Komatsu, Daisuke Sano, Ken-ichiro Yabuki, Yasuhiro Arai, Yukiko Yamashita, Kaoru Yamamoto, Yasunori Sakuma, Nobuhiko Oridate

Published in: International Journal of Clinical Oncology | Issue 5/2016

Abstract

Background

For primary organ preservation, concurrent chemoradiotherapy (CCRT) is performed for advanced squamous cell carcinoma of the head and neck (SCCHN). In this organ-preservation setting with CCRT, surgery is reserved as a salvage treatment in cases of locoregional failure after CCRT. The purpose of the study was to review our experience with salvage surgery after CCRT for patients with SCCHN and to evaluate the effectiveness and prognostic factors affecting survival.

Methods

The records of patients with stage II-IVB SCC of the larynx, oropharynx, or hypopharynx treated with salvage surgery after CCRT between 1998 and 2012 were reviewed.

Results

A total of 645 patients with previously untreated, resectable SCC of the larynx, oropharynx, or hypopharynx received CCRT. Salvage surgery was performed for 78 of 225 patients with residual or recurrent tumors. The 5-year overall survival (OS) and disease-specific survival rates for patients who received salvage surgery were 61.0 and 65.5 %, respectively. Stage IV, poorly differentiated, synchronous double cancer, and surgical complications were significant predictors of unfavorable OS on multivariate analysis. Postoperative complications were observed in 30 patients (38.5 %).

Conclusions

Salvage surgery is the best therapeutic option for failure after CCRT for SCCHN because of its good survival rate, although a high surgical complication rate is seen. Patients with initial stage IV tumors, poorly differentiated SCC, or synchronous double cancer are considered for further adjuvant treatment.

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Title: Treatment results and prognostic factors for advanced squamous cell carcinoma of the head and neck treated with salvage surgery after concurrent chemoradiotherapy
Authors: Takahide Taguchi
Goshi Nishimura
Masahiro Takahashi
Osamu Shiono
Masanori Komatsu
Daisuke Sano
Ken-ichiro Yabuki
Yasuhiro Arai
Yukiko Yamashita
Kaoru Yamamoto
Yasunori Sakuma
Nobuhiko Oridate
Publication date: 01-10-2016
Publisher: Springer Japan
Published in: International Journal of Clinical Oncology / Issue 5/2016
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-016-0964-2

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