Surgical Salvage for Local and Regional Recurrence in Oral Cancer

Surgical Salvage for Local and Regional Recurrence in Oral Cancer
September 2006
Robert A. Ord, DDS, MD, FRCS, MS⁎, Antonia Kolokythas, DDS‹, Mark A. Reynolds, DDS, PhD·
Journal of Oral & Maxillofacial Surgery

Purpose
To evaluate local and regional recurrence and the outcomes for salvage surgery in patients for oral cancer.

Patients and Methods
This study analyzed 354 consecutive patients with oral cancer treated primarily by surgery or surgery combined with adjuvant therapy by 1 surgeon (R.A.O.) between February 1991 and September 2001.

Results
Overall recurrence rate was 15.5%; with 5.4% local, 8.5% regional, and 1.4% locoregional. Overall salvage for local recurrence was 52.6% 3-year survival, and statistically significant favorable prognostic factors were salvaged by surgery alone and initial cancer staging of I/II. Overall salvage for regional recurrence was 50%, with recurrence in a previously untreated neck and salvage with radical neck dissection plus radiotherapy giving the best prognosis. No patients with locoregional recurrence were salvaged.

Conclusions
Patients who were stage I/II and were treated initially by surgery alone were the best candidates for salvage if they recurred. Salvage was best achieved with surgery or surgery + adjuvant therapy, and patients recurring within 6 months had a worse survival. Patients with locoregional recurrence or treated with RT ± chemotherapy alone have negligible survival.

⁎ Professor/Chairman, Department of Oral and Maxillofacial Surgery, University of Maryland, Greenbaum Cancer Center, Baltimore, MD.

‹ Maxillofacial Oncology Fellow, Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, MD.

· Chairman, Department of Periodontology, Baltimore College of Dental Surgery, Baltimore, MD.

Address correspondence and reprint requests to Dr Kolokythas: Department of Oral and Maxillofacial Surgery, University of Maryland, 419 West Redwood Street, Suite 410, Baltimore, MD 21201-1754

PII: S0278-2391(06)00689-6

doi:10.1016/j.joms.2006.05.026

© 2006 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Copyright © 2007 Elsevier, Inc. All rights reserved

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