Advanced soft palate cancer: the clinical importance of the parapharyngeal space.
OBJECTIVE
To identify the incidence of parapharyngeal space (PPS) recurrences and how they impact survival in advanced-stage soft-palate carcinoma patients.


METHODS
One hundred thirty-seven patients' charts were reviewed from 1971 to 1996. Inclusion criteria were patients who received a per-oral resection, discontinuous neck dissection, and postoperative adjuvant radiation therapy; 15 patients met criteria for inclusion. The incidence of PPS recurrences, regional failure, and survival were endpoints that were analyzed.


RESULTS
There were no local failures in our study. Regional failures excluding the PPS (levels I-V) were 27%, and 40% occurred within the PPS. Cervical adenopathy was associated with 83% of the PPS recurrences. Median survival for PPS recurrences was 26 months, compared with 67 months for levels I-V recurrences (n = ns).


CONCLUSIONS
The incidence of PPS recurrences is substantial in advanced-stage soft-palate cancer. PPS recurrences negatively impact survival; without effective salvage techniques for these recurrences or effective adjuvant therapy, poor patient outcomes can be expected.
Douglas
Wade G
WG
Department of Head and Neck, Plastics and Reconstructive Surgery, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
Rigual
Nestor R
NR
Giese
William
W
Bauer
Joseph
J
Wiseman
Sam M
SM
Loree
Thom R
TR
Schwarz
James
J
Alrawi
Sadir
S
Hicks
Wesley L
WL
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology* / Q000556:secondary; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D013517:Otorhinolaryngologic Surgical Procedures; D010157:Palatal Neoplasms / Q000473:pathology*; D010160:Palate, Soft; D010610:Pharyngeal Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000556:secondary; D010614:Pharynx; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis