Risk factors for local-regional recurrence following preoperative radiation therapy and surgery for head and neck cancer (stage II-IVB).
OBJECTIVE
To discover possible risk factors for local-regional recurrence (LRR) following preoperative radiation therapy and curative surgery for head and neck squamous cell carcinoma (SCC) (stage II-IVB).


METHODS
Clinical records from 1987 to 1999 of 161 patients with head and neck SCC (oral cavity, 80 patients; larynx, 50; hypopharynx, 19; oropharynx, 12) who underwent preoperative radiation therapy and surgery were retrospectively reviewed. One hundred thirty-two (82%) of the patients had stage III or IV cancer. The median radiation dose was 38 Gy.


RESULTS
The 5-year overall survival rate and LRR rate were 58% and 35%, respectively. At multivariate analysis, oral cavity cancer (P =.020), clinical T stage (P =.016), clinical N stage (P =.017), and status of surgical margins (P =.008) emerged as variables that were significantly associated with LRR. The analysis of only those patients with lymph node involvement showed that oral cavity cancer (P =.008), advanced N-stage cancer (P =.045), and long interval between the start of preoperative radiation therapy and surgery (> or =7 weeks) (P =.019) emerged as variables that were significantly associated with LRR.


CONCLUSIONS
Oral cavity cancer, advanced T or N stage of disease, and unsatisfactory margins were risk factors for LRR. A long interval (> or =7 weeks) was a risk factor for LRR in patients with lymph node involvement.
Shikama
Naoto
N
Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan. shikama@hsp.md.shinshu-u.ac.jp
Sasaki
Shigeru
S
Nishikawa
Atsushi
A
Koiwai
Keiichirou
K
Yoshino
Fuyumi
F
Hirase
Yuichi
Y
Kawakami
Rei
R
Kadoya
Masumi
M
Oguchi
Masahiko
M
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000628:therapy; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000628:therapy; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000628:therapy; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000628:therapy; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012307:Risk Factors