Salvage surgery for recurrent oropharyngeal cancer after chemoradiotherapy

International Journal of Clinical Oncology - Tập 18 - Trang 817-823 - 2012
Satoshi Kano1, Akihiro Homma2, Ryuichi Hayashi3, Kazuyoshi Kawabata4, Kunitoshi Yoshino5, Shigemichi Iwae6, Yasuhisa Hasegawa7, Kenichi Nibu8, Takakuni Kato9, Kiyoto Shiga10, Kazuto Matsuura11, Nobuya Monden12, Masato Fujii13
1Department of Otolaryngology–Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
2Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
3Division of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
4Department of Head and Neck Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
5Department of Otolaryngology Head and Neck Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
6Department of Head and Neck Surgery, Hyogo Cancer Center, Akashi, Japan
7Department of Head and Neck Surgery, Aichi Cancer Center, Nagoya, Japan
8Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
9Department of Oto-Rhino-Laryngology, Jikei University School of Medicine, Tokyo, Japan
10Department of Otolaryngology-Head and Neck Surgery, Tohoku University School of Medicine, Sendai, Japan
11Division of Head and Neck Surgery, Miyagi Cancer Center, Sendai, Japan
12Department of Otorhinolaryngology-Head and Neck Surgery, National Shikoku Cancer Center, Matsuyama, Japan
13Department of Otorhinolaryngology, National Tokyo Medical Center, Tokyo, Japan

Tóm tắt

The current study aimed to assess the role of salvage surgery for failure cases of oropharyngeal cancer (OPC) undergoing initial chemoradiotherapy (CRT). The data for 523 patients with previously untreated OPC were gathered from 12 institutions belonging to the Head and Neck Cancer Study Group in Japan Clinical Oncology Group (JCOG). Of the 170 patients who received CRT, 35 patients (21 %) had local recurrence or residual disease. Only 11 patients underwent further salvage surgery, and 24 patients received nonsurgical treatment. There were statistically significant differences between the two groups in terms of patient age and the presence of a simultaneous regional recurrence. The 5-year overall survival rates for the patients who underwent salvage surgery were 49.1 %, whereas those for the patients who received nonsurgical treatment were 16.3 %. The initial treatment method for OPC should be decided carefully and the limitations of salvage surgery should be fully considered.

Tài liệu tham khảo

Chen AY, Schrag N, Hao Y et al (2007) Changes in treatment of advanced oropharyngeal cancer, 1985–2001. Laryngoscope 117:16–21 Cohan DM, Popat S, Kaplan SE et al (2009) Oropharyngeal cancer: current understanding and management. Curr Opin Otolaryngol Head Neck Surg 17:88–94 Parsons JT, Mendenhall WM, Stringer SP et al (2002) Squamous cell carcinoma of the oropharynx: surgery, radiation therapy, or both. Cancer (Phila) 94:2967–2980 Ang KK, Harris J, Wheeler R et al (2010) Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med 363:24–35 Fakhry C, Westra WH, Li S et al (2008) Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. J Natl Cancer Inst 100:261–269 Bachar GY, Goh C, Goldstein DP et al (2010) Long-term outcome analysis after surgical salvage for recurrent tonsil carcinoma following radical radiotherapy. Eur Arch Otorhinolaryngol 267:295–301 Taki S, Homma A, Oridate N et al (2010) Salvage surgery for local recurrence after chemoradiotherapy or radiotherapy in hypopharyngeal cancer patients. Eur Arch Otorhinolaryngol 267:1765–1769 Goodwin WJ Jr (2000) Salvage surgery for patients with recurrent squamous cell carcinoma of the upper aerodigestive tract: when do the ends justify the means? Laryngoscope 110:1–18 Agra IM, Carvalho AL, Pontes E et al (2003) Postoperative complications after en bloc salvage surgery for head and neck cancer. Arch Otolaryngol Head Neck Surg 129:1317–1321 Roosli C, Studer G, Stoeckli SJ (2010) Salvage treatment for recurrent oropharyngeal squamous cell carcinoma. Head Neck 32:989–996 Zafereo ME, Hanasono MM, Rosenthal DI et al (2009) The role of salvage surgery in patients with recurrent squamous cell carcinoma of the oropharynx. Cancer (Phila) 115:5723–5733 Weber RS, Berkey BA, Forastiere A et al (2003) Outcome of salvage total laryngectomy following organ preservation therapy: the Radiation Therapy Oncology Group trial 91–11. Arch Otolaryngol Head Neck Surg 129:44–49 Agra IM, Carvalho AL, Ulbrich FS et al (2006) Prognostic factors in salvage surgery for recurrent oral and oropharyngeal cancer. Head Neck 28:107–113 Nichols AC, Kneuertz PJ, Deschler DG et al (2011) Surgical salvage of the oropharynx after failure of organ-sparing therapy. Head Neck 33:516–524 Boscolo-Rizzo P, Stellin M, Fuson R et al (2009) Long-term quality of life after treatment for locally advanced oropharyngeal carcinoma: surgery and postoperative radiotherapy versus concurrent chemoradiation. Oral Oncol 45:953–957