title: Second salvage surgery for re-recurrent oral cavity and oropharynx carcinoma.
abstract: BACKGROUND
  Salvage surgery is considered the best treatment approach for patients with recurrent oral carcinoma. Unfortunately, 50% to 60% of the patients who undergo salvage surgery will develop further locoregional recurrence, and they are not usually considered for further treatment. Our aim in this study was to report our experience with a second salvage surgery for selected patients with re-recurrent oral cavity and oropharyngeal squamous cell carcinoma (SCC).
  
  
  METHODS
  Forty-one patients underwent a second salvage surgical procedure, with curative intention for re-recurrent oral cancer. The surgical treatment used was wide local resection in 34 cases, neck dissection in 9 cases, and isolated neck dissection in 7 cases.
  
  
  RESULTS
  Cancer-specific survival (CSS) rate in 3 years was at 20%. Patients with re-recurrence in <6 months presented 3-year CSS null, whereas patients with re-recurrence after 6 months presented 3-year CSS of 32.3% (p = .007).
  
  
  CONCLUSIONS
  Second salvage surgery can be considered a potentially curative therapeutic approach for a selected group of patients with re-recurrent oral SCC. The disease-free interval was the main clinical factor associated with the prognosis.
authors.affiliation: Head and Neck Surgery Department, Hospital Aristides Maltez, Salvador, Brazil.
authors.forename: Ivan Marcelo Gonçalves
authors.initials: IM
authors.lastname: Agra
authors.forename: João Gonçalves
authors.initials: JG
authors.lastname: Filho
authors.forename: Everton Pontes
authors.initials: EP
authors.lastname: Martins
authors.forename: Luiz Paulo
authors.initials: LP
authors.lastname: Kowalski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D016879:Salvage Therapy; D015996:Survival Rate; D016896:Treatment Outcome