Abstract
Objectives:
A local recurrence of pharyngeal carcinoma (PC) after definitive radiotherapy (RT) or chemoradiotherapy (CRT) is correlated to a poor prognosis. Therefore, the objective of the current study was to analyze the efficacy of salvage surgery for patients with locally recurrent PC after RT or CRT.
Methods:
We retrospectively reviewed the clinical charts of patients with PC treated between 2001 and 2011 at the University of Tokyo Hospital and enrolled 222 patients, including 106 with oropharyngeal carcinoma (OPC) and hypopharyngeal carcinoma (HPC) who received definitive RT or CRT. Local recurrence developed in 63 patients (26 OPC and 37 HPC), of whom 44 (18 OPC and 26 HPC) underwent salvage surgery. Initial treatments were radiotherapy, radiotherapy with induction chemotherapy, and concurrent chemoradiotherapy in 13, 11, and 20 patients, respectively. The median radiation dose was 70 Gy.
Results:
Resection of the local recurrence was combined with free or pedicle flap reconstruction in 38 patients and was performed without reconstruction in 8. Twenty-eight patients simultaneously underwent laryngectomy and resection. The median overall survival (OS) and median disease-free survival (DFS) after salvage surgery was 16 and 10 months, respectively. The DFS of HPC patients (median, 15 months; 2-year OS rate, 43%) was significantly longer than that of OPC patients (median, 7 months; 2-year OS rate, 12%; P = 0.01).
Conclusion:
The prognosis of locally recurrent PC remains poor despite the technical feasibility of salvage surgery, with the prognosis for HPC being significantly better than that for OPC.
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