Clinical outcome of salvage neck dissections in head and neck cancer in relation to initial treatment, extent of surgery, and patient factors

Abstract

Objective

Salvage surgery has a higher complication rate compared to primary surgical treatment. We evaluated clinical outcome of salvage neck dissections in relation to initial treatment modality, extent of surgery, and patient related factors.

Design

Single institution consecutive case series.

Setting

Tertiary Head and Neck Cancer Center.

Participants

Eighty-seven patients with head and neck squamous cell carcinoma, who underwent salvage neck dissection after initial radiotherapy (n=30), radiotherapy with carboplatin/5-fluorouracil (n=43), or radiotherapy with cetuximab (n=14).

Main outcome measures

Incidence of complications, disease-specific survival.

Results: Complications occurred in 28% of the patients. Multivariate analysis identified extent of neck dissection as the only independent predictor of surgical complications (p = .010). Surgical complication rate was 16% after radiotherapy with systemic treatment, and 47% after radiotherapy alone (p = .171). The 5-year disease-specific survival was 55%, independent of complications, initial treatment, extent of surgery, and patient related factors.

Conclusion

The only predictor for surgical complications was extent of surgery. Survival was not influenced by complications.

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