Outcomes and Affecting Factors in the Management of Regional Recurrence in Head & Neck Squamous Cell Carcinoma.

Jeong, Woo Jin; Hah, Jeong Hun; Kwon, Seong Keun; Jung, Young Ho; Kim, Sang Wook; Kwon, Tack Kyun; Sung, Myung Whun; Kim, Kwang Hyun

Abstract

BACKGROUND AND OBJECTIVES: Regional recurrence of head and neck squamous cell carcinoma (HNSCC) is the most common single type of treatment failure, and thus a challenging problem for the clinician. When planning management of regional recurrence, the grave outcome of the recurrence itself, and benefits and morbidity owing to the intervention must be taken into account. We analyzed the factors affecting salvage treatment outcomes of regional recurrence in head & neck squamous cell carcinoma.
SUBJECTS AND METHOD
A retrospective analysis of medical records over a 10 year period (1994-2003) was conducted. Sixty-two patients with regional and locoregional recurrence were identified. Patients with local recurrence or distant metastasis were excluded.
RESULTS
The median age of the population was 62 years. Sixty percent of the cases were regional, and the remainders were locoregional recurrences. The median time of recurrence was 16 months with an overall survival rate of 46.1%. Recurrence in a surgically virginal neck was associated with a favorable outcome. Factors associated with poor outcomes were node positive at initial presentation, neck dissection at initial treatment, recurrence at contralateral neck, incorporation of chemotherapy for salvage treatment, and subsequent recurrence after salvage treatment.
CONCLUSION
In the management of patients with regional recurrence of HNSCC, the factors mentioned above should be taken into consideration regarding patient selection, salvage management plan, and patient counseling.