The Current Role of Salvage Surgery in Recurrent Head and Neck Squamous Cell Carcinoma
Chemoradiotherapy has emerged as a gold standard in advanced squamous cell carcinoma of the head and neck (SCCHN). Because 50% of advanced stage patients relapse after nonsurgical primary treatment, the role of salvage surgery (SS) is critical because surgery is generally regarded as the best treatm...
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2018-08-01
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doaj-da82d5078a81428e86e5e42b156cd0402020-11-24T21:17:19ZengMDPI AGCancers2072-66942018-08-0110826710.3390/cancers10080267cancers10080267The Current Role of Salvage Surgery in Recurrent Head and Neck Squamous Cell CarcinomaMarc Hamoir0Sandra Schmitz1Carlos Suarez2Primoz Strojan3Kate A Hutcheson4Juan P Rodrigo5William M Mendenhall6Ricard Simo7Nabil F Saba8Anil K D‘Cruz9Missak Haigentz10Carol R Bradford11Eric M Genden12Alessandra Rinaldo13Alfio Ferlito14Department of Head and Neck Surgery, King Albert II Cancer Institute, St Luc University Hospital, 1200 Brussels, BelgiumDepartment of Head and Neck Surgery, King Albert II Cancer Institute, St Luc University Hospital, 1200 Brussels, BelgiumInstituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, 33011 Oviedo, SpainDepartment of Radiation Oncology, Institute of Oncology, Ljubljana SI-1000, SloveniaDepartment of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77006, USADepartment of Otolaryngology, Hospital Universitario Central de Asturias, IUOPA, University of Oviedo, CIBERONC, 33011 Oviedo, SpainDepartment of Radiation Oncology, University of Florida, Gainesville, FL 32610-0385, USAHead and Neck Cancer Unit, Guy’s and St Thomas’ Hospital NHS Foundation Trust, London SE1 9RT, UKDepartment of Hematology and Medical Oncology, The Winship Cancer Institute of Emory University, Atlanta, GA 30305, USAHead Neck Services, Tata Memorial Hospital, Parel Mumbai 400012, IndiaDivision of Hematology/Oncology, Department of Medicine, Morristown Medical Center/Atlantic Health System, Morristown, NJ 07960, USADepartment of Otolaryngology—Head and Neck Surgery, University of Michigan, Ann Arbor, MI 48109, USADepartment of Otolaryngology—Head and Neck Surgery, Mount Sinai Medical Center, New York, NY 10029, USAUniversity of Udine School of Medicine, 33100 Udine, ItalyInternational Head and Neck Scientific Group, 35030 Padua, ItalyChemoradiotherapy has emerged as a gold standard in advanced squamous cell carcinoma of the head and neck (SCCHN). Because 50% of advanced stage patients relapse after nonsurgical primary treatment, the role of salvage surgery (SS) is critical because surgery is generally regarded as the best treatment option in patients with recurrent resectable SCCHN. Surgeons are increasingly confronted with considering operation among patients with significant effects of failed non-surgical primary treatment. Wide local excision to achieve clear margins must be balanced with the morbidity of the procedure, the functional consequences of organ mutilation, and the likelihood of success. Accurate selection of patients suitable for surgery is a major issue. It is essential to establish objective criteria based on functional and oncologic outcomes to select the best candidates for SS. The authors propose first to understand preoperative prognostic factors influencing survival. Predictive modeling based on preoperative information is now available to better select patients having a good chance to be successfully treated with surgery. Patients with a high comorbidity index, advanced oropharyngeal or hypopharyngeal primary tumors, and both local and regional recurrence have a very limited likelihood of success with salvage surgery and should be strongly considered for other treatments. Following SS, identifying patients with postoperative prognostic factors predicting high risk of recurrence is essential because those patients could benefit of adjuvant treatment or be included in clinical trials. Finally, defining HPV tumor status is needed in future studies including recurrent oropharyngeal SCC patients.http://www.mdpi.com/2072-6694/10/8/267cancer recurrencehead and neck cancersquamous cell carcinomatreatment failuresalvage surgery |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Marc Hamoir Sandra Schmitz Carlos Suarez Primoz Strojan Kate A Hutcheson Juan P Rodrigo William M Mendenhall Ricard Simo Nabil F Saba Anil K D‘Cruz Missak Haigentz Carol R Bradford Eric M Genden Alessandra Rinaldo Alfio Ferlito |
spellingShingle |
Marc Hamoir Sandra Schmitz Carlos Suarez Primoz Strojan Kate A Hutcheson Juan P Rodrigo William M Mendenhall Ricard Simo Nabil F Saba Anil K D‘Cruz Missak Haigentz Carol R Bradford Eric M Genden Alessandra Rinaldo Alfio Ferlito The Current Role of Salvage Surgery in Recurrent Head and Neck Squamous Cell Carcinoma Cancers cancer recurrence head and neck cancer squamous cell carcinoma treatment failure salvage surgery |
author_facet |
Marc Hamoir Sandra Schmitz Carlos Suarez Primoz Strojan Kate A Hutcheson Juan P Rodrigo William M Mendenhall Ricard Simo Nabil F Saba Anil K D‘Cruz Missak Haigentz Carol R Bradford Eric M Genden Alessandra Rinaldo Alfio Ferlito |
author_sort |
Marc Hamoir |
title |
The Current Role of Salvage Surgery in Recurrent Head and Neck Squamous Cell Carcinoma |
title_short |
The Current Role of Salvage Surgery in Recurrent Head and Neck Squamous Cell Carcinoma |
title_full |
The Current Role of Salvage Surgery in Recurrent Head and Neck Squamous Cell Carcinoma |
title_fullStr |
The Current Role of Salvage Surgery in Recurrent Head and Neck Squamous Cell Carcinoma |
title_full_unstemmed |
The Current Role of Salvage Surgery in Recurrent Head and Neck Squamous Cell Carcinoma |
title_sort |
current role of salvage surgery in recurrent head and neck squamous cell carcinoma |
publisher |
MDPI AG |
series |
Cancers |
issn |
2072-6694 |
publishDate |
2018-08-01 |
description |
Chemoradiotherapy has emerged as a gold standard in advanced squamous cell carcinoma of the head and neck (SCCHN). Because 50% of advanced stage patients relapse after nonsurgical primary treatment, the role of salvage surgery (SS) is critical because surgery is generally regarded as the best treatment option in patients with recurrent resectable SCCHN. Surgeons are increasingly confronted with considering operation among patients with significant effects of failed non-surgical primary treatment. Wide local excision to achieve clear margins must be balanced with the morbidity of the procedure, the functional consequences of organ mutilation, and the likelihood of success. Accurate selection of patients suitable for surgery is a major issue. It is essential to establish objective criteria based on functional and oncologic outcomes to select the best candidates for SS. The authors propose first to understand preoperative prognostic factors influencing survival. Predictive modeling based on preoperative information is now available to better select patients having a good chance to be successfully treated with surgery. Patients with a high comorbidity index, advanced oropharyngeal or hypopharyngeal primary tumors, and both local and regional recurrence have a very limited likelihood of success with salvage surgery and should be strongly considered for other treatments. Following SS, identifying patients with postoperative prognostic factors predicting high risk of recurrence is essential because those patients could benefit of adjuvant treatment or be included in clinical trials. Finally, defining HPV tumor status is needed in future studies including recurrent oropharyngeal SCC patients. |
topic |
cancer recurrence head and neck cancer squamous cell carcinoma treatment failure salvage surgery |
url |
http://www.mdpi.com/2072-6694/10/8/267 |
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