title: Surgical salvage of the oropharynx after failure of organ-sparing therapy.
abstract: BACKGROUND
  The purpose of this study was to evaluate the efficacy of salvage surgery for local recurrences of oropharyngeal squamous cell carcinoma (OPSCC) and identify predictors of survival.
  
  
  METHODS
  The authors reviewed 264 patients with OPSCC treated with radiation or chemoradiation identified retrospectively. Of the 77 patients that experienced recurrences, 37 had local or local and regional recurrences and were considered for salvage surgery.
  
  
  RESULTS
  Of the 37 patients with local or local and regional recurrence, 5 had unresectable disease whereas 3 refused surgery. The remainder underwent salvage surgery with 2-year and 5-year survival rates of 64.5% and 43.4%, respectively. A history of alcohol abuse and positive surgical margins were the only predictors of poorer overall survival (p < .05) after salvage surgery.
  
  
  CONCLUSIONS
  Surgical salvage of locoregional recurrences can be effective if wide resections are performed so that negative margins can be achieved.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada.
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Nichols
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Kneuertz
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Deschler
authors.forename: Derrick T
authors.initials: DT
authors.lastname: Lin
authors.forename: Kevin S
authors.initials: KS
authors.lastname: Emerick
authors.forename: John R
authors.initials: JR
authors.lastname: Clark
authors.forename: Paul W
authors.initials: PW
authors.lastname: Busse
authors.forename: James W
authors.initials: JW
authors.lastname: Rocco
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009960:Oropharynx / Q000601:surgery*; D016879:Salvage Therapy / Q000009:adverse effects; D015996:Survival Rate