Outcomes for recurrent oral cavity squamous cell carcinoma

Area of Science:

• Oncology
• Surgical Oncology
• Head and Neck Cancer Research

Background:

• Locally recurrent oral cavity squamous cell carcinoma (OCSCC) presents significant treatment challenges.
• Evaluating outcomes of salvage surgery is crucial for patient management.

Purpose of the Study:

• To determine overall survival (OS), prognostic factors, cost, and functional outcomes after salvage surgery for locally recurrent OCSCC.
• To identify predictors of survival and functional recovery in this patient population.

Main Methods:

• Retrospective review of 399 cases of locally recurrent OCSCC (1997-2011).
• Analysis of 259 patients treated with salvage surgery.
• Evaluation of survival and prognostic factors using Cox regression, Kaplan-Meier method, and log-rank test.

Main Results:

• Five-year OS was 44.2% for surgical salvage versus 1.5% for nonsurgical therapy.
• Factors associated with poorer OS included disease-free interval ≤ 6 months, recurrent stage III-IV disease, and prior radiation.
• Favorable functional outcomes: 85% speech intelligibility, 81% oral intake, 78% tracheostomy decannulation.
• Median adjusted charges were $129,696.

Conclusions:

• Salvage surgery for recurrent OCSCC yields moderate survival and good functional outcomes.
• Prognosis is poorer for patients with advanced disease, short disease-free intervals, or prior radiation.
• Treatment is costly and recurrence remains a significant concern for approximately half of patients.