SURGICAL SALVAGE OF THE OROPHARYNX AFTER FAILURE OF ORGAN-SPARING THERAPY

Background. The purpose of this study was to evaluate the efficacy of salvage surgery for local recurrences of oropharyngeal squamous cell carcinoma (OPSCC) and identify predictors of survival. Methods. The authors reviewed 264 patients with OPSCC treated with radiation or chemoradiation identified retrospectively. Of the 77 patients that experienced recurrences, 37 had local or local and regional recurrences and were considered for salvage surgery. Results. Of the 37 patients with local or local and regional recurrence, 5 had unresectable disease whereas 3 refused surgery. The remainder underwent salvage surgery with 2-year and 5-year survival rates of 64.5% and 43.4%, respectively. A history of alcohol abuse and positive surgical margins were the only predictors of poorer overall survival (p < .05) after salvage surgery. Conclusion. Surgical salvage of locoregional recurrences can be effective if wide resections are performed so that negative margins can be achieved. (C) 2010 Wiley Periodicals, Inc. Head Neck 33: 516-524, 2011