Authors: Takahide Taguchi Goshi Nishimura Masahiro Takahashi Osamu Shiono Masanori Komatsu Daisuke Sano Kenichiro Yabuki Yasuhiro Arai Yukiko Yamashita Kaoru Yamamoto Yasunori Sakuma Nobuhiko Oridate
Publish Date: 2016/02/23
Volume: 21, Issue: 5, Pages: 869-874
Abstract
For primary organ preservation concurrent chemoradiotherapy CCRT is performed for advanced squamous cell carcinoma of the head and neck SCCHN In this organpreservation 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 survivalA 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 5year overall survival OS and diseasespecific survival rates for patients who received salvage surgery were 610 and 655 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 385 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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