Salvage surgery for recurrent carcinoma of the oral cavity: assessment of prognostic factors

Int J Oral Maxillofac Surg. 2022 May;51(5):602-611. doi: 10.1016/j.ijom.2021.07.020. Epub 2021 Aug 19.

Abstract

Salvage surgery is the most acceptable therapeutic option for disease control of loco-regional recurrences in oral cancers. Prognostic factors need to be assessed to select patients for salvage surgery who would benefit the most. This was a single-centre retrospective observational study conducted between 2015 and 2018. A total of 168 patients with recurrent oral cavity carcinoma who underwent salvage surgery were included for analysis. The primary endpoints of the study were to evaluate overall survival (rOS) after salvage surgery and prognostic factors affecting survival. In this study, the median rOS was 18 months and the median disease-free survival (rDFS) was 14 months. Advanced stage (hazard ratio (HR) 2.387, 95% confidence interval (CI) 1.496-3.808; P = 0.001) and multimodality treatment (HR 1.642, 95% CI 1.139-2.367; P = 0.008) in the initial disease, as well as nodal spread (HR 3.794, 95% CI 1.580-9.111; P = 0.008) and perineural invasion (HR 2.167, 95% CI 1.358-3.455; P = 0.001) in the recurrent disease, were found to adversely affect survival after salvage surgery. With thorough assessment of the prognostic factors and appropriate patient selection, survival may be favourable after salvage surgery for recurrent oral cavity carcinoma.

Keywords: head and neck squamous cell carcinomas; locoregional neoplasm; oral cavity squamous cell carcinoma; prognostic factors; recurrence.

Publication types

  • Observational Study

MeSH terms

  • Carcinoma, Squamous Cell* / pathology
  • Chronic Disease
  • Head and Neck Neoplasms*
  • Humans
  • Mouth Neoplasms* / pathology
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery
  • Prognosis
  • Reactive Oxygen Species
  • Retrospective Studies
  • Salvage Therapy

Substances

  • Reactive Oxygen Species