Source:Journal of Oral and Maxillofacial Surgery
Author(s): Narayana Subramaniam, Deepak Balasubramanian, Tsu-Hui Hubert Low, Samskruthi Murthy, Jonathan R. Clark, Krishnakumar Thankappan, Subramania Iyer
PurposeTo determine the factors affecting outcome in surgically salvaged, locoregionally recurrent squamous cell carcinoma of the tongue (SCCT)MethodsIn a retrospective cohort of patients who underwent successful salvage of locoregionally recurrent SCCT we performed this observational analytical study to determine survival and their determinants. Details extracted from the database were patients characteristics (age, gender, tobacco use), treatment characteristics and characteristics of recurrent disease (stage, adverse pathological features like grade, perineural invasion, lymphovascular invasion, etc). Overall survival (OS) curves were plotted using Kaplan Meier method. Cox proportional hazards model was used to determine impact of patient, disease and treatment characteristics on OS.ResultsFrom 52 patients with locoregional recurrences of surgically treated SCCT, 25 (48.1%) patients underwent surgical salvage with curative intent. The median overall OS for this cohort was 26 months. Factors predictive of worse OS were previous adjuvant therapy (p=0.016) and increasing adverse pathological features (APFs) in recurrent tumour histology (p=0.008). Lymphovascular invasion in recurrent tumour histology and those with a disease free interval of <6 months showed worse survival (p=0.008 and p=0.058 respectively).ConclusionAmong patients with locoregional recurrence, the number of patients who are eligible for curative intent surgical salvage is small. Those who received previous adjuvant therapy and those with increasing APFs in recurrent tumours had poor outcome in spite of attempt with surgical salvage, particularly patients with early recurrence.
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