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  3. Multidisciplinary Evidence-based Consensus Statements On Salvage Surgery For Recurrent Head And Neck Cancer (international Centre For Recurrent Head And Neck Cancer).
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Multidisciplinary Evidence-based Consensus Statements On Salvage Surgery For Recurrent Head And Neck Cancer (international Centre For Recurrent Head And Neck Cancer).

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Multidisciplinary evidence-based consensus statements on salvage surgery for recurrent head and neck cancer

Andrew Williamson1,2, Grainne Brady3, Natalie Harris4

  • 1International Centre for Recurrent Head and Neck Cancer, The Royal Marsden Hospital, London, United Kingdom.

Journal of the National Cancer Institute
|June 14, 2025

View abstract on PubMed

Summary
This summary is machine-generated.

This study provides expert consensus on managing recurrent head and neck squamous cell carcinomas (rHNSCC) with salvage surgery. It offers guidance for multidisciplinary teams to improve patient outcomes and quality of life.

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Head and Neck Cancer Research

Background:

  • Recurrent head and neck squamous cell carcinomas (rHNSCC) lack high-quality evidence and standardized management.
  • Significant practice variations exist for rHNSCC due to limited gold-standard recommendations.
  • This project focused on developing expert consensus for rHNSCC managed with curative salvage surgery.

Purpose of the Study:

  • To establish a national multi-disciplinary expert consensus for rHNSCC patients undergoing curative salvage surgery.
  • To provide evidence-based best practice statements for perioperative management and surgical salvage.
  • To address the understudied nature of rHNSCC and reduce practice variability.

Main Methods:

  • A Delphi process guided by the AGREEII protocol was employed.
  • Literature review informed the development of best practice statements for major rHNSCC subsites.
  • UK-based experts from the IREC network and professional organizations participated in a three-round online Delphi study.

Main Results:

  • Twenty-eight experts, including otolaryngologists, oncologists, and surgeons, participated.
  • Consensus was reached on 73 statements regarding the management of rHNSCC.
  • A high level of agreement was achieved, with 39.7% unanimous and 34.2% >90% agreement.

Conclusions:

  • Salvage surgery for rHNSCC demands intensive multidisciplinary input for curative outcomes.
  • Balancing cure with functional impact and quality of life is crucial in managing rHNSCC.
  • The consensus statements provide guidance for complex intra- and perioperative management in surgical salvage.