Open AccessA Survival Analysis for Primary and Salvage Ablative Surgery with Microvascular Reconstruction for Squamous Cell Carcinoma of the Upper Aerodigestive Tract
Author(s) -
Boeckmann Jacob O.,
Spencer Horace,
Vural Emre A.,
Suen James Y.,
Yuen James C.
Publication year - 2011
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599811415823a84
Subject(s) - medicine , surgery , salvage therapy , ablative case , basal cell , stage (stratigraphy) , salvage surgery , carcinoma , radiation therapy , chemotherapy , paleontology , biology
Objective Provide prognostic data for the physicians and patients when a decision is made for primary or salvage ablative surgery of the upper aerodigestive tract with the aide of microvascular reconstruction. Method Retrospective chart review of patients with primary or recurrent upper aerodigestive tract squamous cell carcinoma treated with free flap reconstruction between 1993 and 2009. Prior treatment, recurrence time and site, sex, age, complications, cause of death, stage, and survival rates were analyzed. Results A total of 219 patients were identified. Mean age was 59.6 years. A total of 136 patients underwent primary resection with immediate reconstruction, 83 patients underwent salvage treatment. A total of 196 patients had advanced clinical stage oral (n = 129) and oropharyngeal squamous cell carcinomas (n = 51). Median overall survival for all patients was 21.7 months (CI 16.2, 33.1) with median recurrence free survival of 12.6 months (CI 8.8, 16.6). Median overall survival was 31.3 months (CI 18.6, 48.6) for primary resection group and 14.6 months for salvage group (CI 11.4, 21.5). Recurrence free median survival was 16.6 months for the primary resection group and 7.7 months for salvage group ( P =. 009). Conclusion The surgeon and the patient need to be aware of survival rates, when radical resection with free flap reconstruction offered; especially in salvage setting. This may help the patient and the surgeon in choosing the most suitable treatment modality for any given condition.