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Prognostic factors and outcomes for salvage surgery in patients with recurrent squamous cell carcinoma of the tongue
Author(s) -
Goto Mitsuo,
Hanai Nobuhiro,
Ozawa Taijiro,
Hirakawa Hitoshi,
Suzuki Hidenori,
Hyodo Ikuo,
Kodaira Takeshi,
Ogawa Tetsuya,
Fujimoto Yasushi,
Terada Akihiro,
Kato Hisakazu,
Hasegawa Yasuhisa
Publication year - 2016
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12087
Subject(s) - medicine , salvage therapy , univariate analysis , salvage surgery , stage (stratigraphy) , surgery , multivariate analysis , tongue , oncology , cervical lymph nodes , lymph , cancer , radiation therapy , chemotherapy , metastasis , pathology , paleontology , biology
Aim Recurrence rates of oral cancer following primary treatment have been reported in the range of 25–48%. However, salvage therapy remains a critical challenge to improving outcomes. Here, we investigated prognostic factors and outcomes for salvage surgery in patients with recurrent oral tongue squamous cell carcinoma ( OTSCC ). Methods We retrospectively reviewed patients who were referred to A ichi C ancer C enter, J apan, for the treatment of recurrent OTSCC . All patients included in the present study had undergone salvage surgery. Data to identify the predictive value of prognostic factors were available from 69 patients. Prognostic factors were assessed using C ox's proportional hazards regression analysis. Differences in overall survival between groups of patients were assessed by the log–rank test. Results In all, 36 patients (52%) developed second recurrence or died, of which 21 (58%) occurred within 12 months of salvage surgery. Univariate analysis indicated that survival was significantly worse in patients with recurrent stage III or IV tumors, two or more positive cervical lymph nodes, levels IV or V positive cervical lymph nodes, extracapsular spread ( ECS ) of positive cervical lymph nodes and a disease‐free interval from initial treatment of less than 12 months. On multivariate analysis, ECS was an independent prognostic factor for overall survival after salvage surgery. Conclusion Neck status at the time of salvage surgery, particularly ECS is a significant prognostic factor for surgical salvage. Survival was also influenced by the stage of the recurrent tumor and disease‐free interval, suggesting that the biological features of recurrent tumors might impact on prognosis.