Salvage surgery for recurrent neck carcinoma after multimodality therapy

Area of Science:

• Oncology
• Surgical Oncology
• Vascular Surgery

Background:

• Recurrent neck carcinoma after radical neck dissection and radiotherapy presents a significant clinical challenge.
• Tumor recurrence with carotid artery involvement often leads to a poor prognosis without further intervention.

Purpose of the Study:

• To evaluate the feasibility and outcomes of salvage surgery with carotid artery resection and replacement in patients with advanced recurrent neck cancer.

Main Methods:

• Ten salvage procedures involving carotid artery resection and replacement were performed on nine patients with fixed, recurrent neck tumors and carotid artery involvement.
• Subclavian artery was frequently used for proximal anastomosis.
• Myocutaneous flaps were employed for resurfacing.

Main Results:

• One patient experienced transient hemiparesis, and another had permanent hemiparesis.
• Three patients survived beyond 12 months.
• One patient achieved disease-free survival at 42 months post-operatively after two salvage operations.
• Low operative morbidity was attributed to surgical techniques.

Conclusions:

• Salvage surgery with carotid artery replacement is a viable option for selected patients with recurrent neck cancer who have failed previous treatments.
• This procedure can serve as a palliative and potentially curative measure.