Salvage surgery in head and neck cancer: External validation of predictors of disease-specific survival

Miquel Quer; Xavier León; Maria Casasayas; Aina Sansa; Montserrat López; Jacinto García Lorenzo

doi:10.1016/j.oraloncology.2020.104876

Salvage surgery in head and neck cancer: External validation of predictors of disease-specific survival

Oral Oncol. 2020 Jun 29:109:104876. doi: 10.1016/j.oraloncology.2020.104876. Online ahead of print.

Authors

Miquel Quer¹, Xavier León², Maria Casasayas³, Aina Sansa³, Montserrat López³, Jacinto García Lorenzo³

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, University Hospital de la Santa Creu i Sant Pau, Universitat Autonòma de Barcelona, Barcelona, Spain. Electronic address: mquer@santpau.cat.
² Department of Otolaryngology-Head and Neck Surgery, University Hospital de la Santa Creu i Sant Pau, Universitat Autonòma de Barcelona, Barcelona, Spain; Oncogenesis and Antitumor Drugs Group, Biomedical Research Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.
³ Department of Otolaryngology-Head and Neck Surgery, University Hospital de la Santa Creu i Sant Pau, Universitat Autonòma de Barcelona, Barcelona, Spain.

PMID: 32615457
DOI: 10.1016/j.oraloncology.2020.104876

Abstract

Objective: Salvage surgery in recurrent head and neck squamous cell carcinoma (HNSCC) is associated with poor outcomes. There is great interest to better identify suitable surgical patients. This study aimed to validate the proposal of Hamoir et al. to use three items to predict the outcomes of salvage surgery.

Materials and methods: Single-center analysis of 577 patients undergoing salvage surgery for recurrent HNSCC during the period 1985-2016, with a minimal follow-up of 2 years. Patients were classified according to the prediction modeling proposed by Hamoir et al. This prediction modeling is based on three predictors: the tumor site (larynx vs non-larynx), initial staging (stage I-II vs stage III-IV), and site of recurrence (local or regional vs locoregional).

Results: Five-year disease-specific survival after salvage surgery was 54.0% (95% CI: 49.6-58.4%). Applying the prediction modeling tested, a total of 212 patients (36.7%) patients had no predictors of poor prognosis, 185 (32.1%) had one predictor, 146 (25.3%) two predictors, and 34 (5.9%) three predictors. Five-year disease-specific survival for patients with none, one, two and three predictors were 82.2%, 47.2%, 29.5% and 20.2% respectively (P = 0.0001).

Conclusions: We have validated the prediction modeling based on the location of the tumor, initial staging and locoregional recurrence proposed by Hamoir et al. This prediction model is easy to apply and provides good information about the possibilities of success of salvage surgery.