Outcome in patients with isolated regional recurrence after primary radiotherapy for head and neck cancer

Anne Marie Lindegaard; Christian von Buchwald; Jacob H Rasmussen; Lena Specht; Ivan R Vogelius; Martin Zamani; Nina Claire Woller; Giedrius Lelkaitis; Jeppe Friborg

doi:10.1002/hed.26361

Outcome in patients with isolated regional recurrence after primary radiotherapy for head and neck cancer

Head Neck. 2020 Nov;42(11):3161-3170. doi: 10.1002/hed.26361. Epub 2020 Jul 18.

Authors

Anne Marie Lindegaard¹, Christian von Buchwald², Jacob H Rasmussen², Lena Specht¹, Ivan R Vogelius¹, Martin Zamani², Nina Claire Woller³, Giedrius Lelkaitis³, Jeppe Friborg¹

Affiliations

¹ Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
² Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
³ Department of Pathology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

PMID: 32681703
DOI: 10.1002/hed.26361

Abstract

Background: Isolated regional recurrences following head-neck squamous-cell carcinomas (HNSCC) are often accessible for curatively intended salvage treatment. Factors prognostic for outcome were investigated in a large cohort of HNSCC patients.

Methods: In total, 1811 patients receiving curatively intended radiotherapy from 2007 to 2017 were reviewed and isolated cervical nodal recurrences were identified. Factors associated with survival and second recurrence were investigated using univariate and multivariate analyses.

Results: Isolated regional recurrence was seen in 95/1811 (5.2%) patients. Eighty of 95 patients (84%) received salvage surgery. Two-year survival after isolated regional recurrence was 40%. Overall survival (OS) and time to second recurrence were associated with resection status of the salvage surgery and presence of extranodal spread (ENS), while p16-positive oropharyngeal squamous-cell carcinoma (OPSCC) was associated with better OS.

Conclusion: Long-term survival after regional recurrence in HNSCC is possible. p16-positive OPSCC, complete salvage surgery, and lack of ENS are associated with better outcome.

Keywords: head and neck cancer; prognostic factors; recurrence; salvage treatment; survival.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Head and Neck Neoplasms* / radiotherapy
Head and Neck Neoplasms* / surgery
Humans
Neoplasm Recurrence, Local*
Prognosis
Retrospective Studies
Salvage Therapy
Squamous Cell Carcinoma of Head and Neck / radiotherapy
Squamous Cell Carcinoma of Head and Neck / surgery