title: Prognostic factors in salvage surgery for recurrent oral and oropharyngeal cancer.
abstract: BACKGROUND
  Therapeutic decisions in recurrent oral and oropharyngeal squamous carcinoma (SCC) remain controversial.
  
  
  METHODS
  Two hundred forty-six consecutive patients who underwent salvage surgery for recurrent squamous cell carcinoma (SCC) of the oral cavity and oropharynx were studied. The tumor sites were lip, 33 cases; oral cavity, 143; oropharynx, 70. The previous treatment was surgery in 73 patients, radiotherapy in 96, combined surgery and radiotherapy in 76, and chemotherapy in one. The clinical stage of recurrence was I/II in 51 cases and III/IV in 195 cases. The disease-free interval (DFI) was less than 1 year in 156 cases and greater than 1 year in 90 cases.
  
  
  RESULTS
  The rate of recurrence was 54.9%, and the overall 5-year actuarial survival rate was 32.3%. The significant prognostic factors in multivariate analysis were restage (p = .049) and DFI (p = .045).
  
  
  CONCLUSIONS
  Patients with recurrent oral and oropharyngeal SCC at initial clinical stages (rCS I and II) and with a DFI greater than 1 year had a favorable prognosis.
authors.affiliation: Head and Neck Surgery and Otorhinolaryngology Department, Centro de Tratamento e Pesquisa Hospital do Câncer A C Camargo, Rua Professor Antonio Prudente, 211, 01509-900 São Paulo, Brazil.
authors.forename: Ivan Marcelo Gonçalves
authors.initials: IM
authors.lastname: Agra
authors.forename: André Lopes
authors.initials: AL
authors.lastname: Carvalho
authors.forename: Fábio Samsonovski
authors.initials: FS
authors.lastname: Ulbrich
authors.forename: Olímpio Daniel
authors.initials: OD
authors.lastname: de Campos
authors.forename: Everton Pontes
authors.initials: EP
authors.lastname: Martins
authors.forename: José
authors.initials: J
authors.lastname: Magrin
authors.forename: Luiz Paulo
authors.initials: LP
authors.lastname: Kowalski
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate