title: Salvage surgery for recurrent oropharyngeal cancer: post-operative oncologic and functional outcomes.
abstract: CONCLUSIONS
  Post-operative outcomes of salvage surgery for recurrent oropharyngeal squamous-cell carcinoma (OPSCC) were acceptable. Pathologic overall, T- or N-stage and patient comorbidities were the main predictors of patient clinical outcomes.
  
  
  OBJECTIVE
  To evaluate post-operative outcomes of salvage surgery in patients with recurrent OPSCC and to determine their predictive factors.
  
  
  METHODS
  This study retrospectively reviewed the electronic medical records of all patients who underwent salvage surgery for recurrent OPSCC, between 2000-2013, in our institution. Overall survival (OS) and cause-specific survival (SS) were determined by Kaplan-Meier analysis. Predictive factors of post-operative outcomes were investigated by using univariate and multivariate analyses.
  
  
  RESULTS
  A total of 34 patients were included in this study. Local and general post-operative complication rates were 26% and 27%, respectively. A high level of comorbidity (Kaplan Feinstein Index: KFI ≥ 2) was the only factor associated with a higher risk of local (p = 0.03) and general (p = 0.04) complications. OS and SS rates at 3 years were 48% and 61%, respectively. In multivariate analysis, pathologic overall stage ≥ III was a significant predictor of OS (p = 0.02) and pathologic T-stage ≥ 3 was a significant predictor of SS (p = 0.01). Mean pre-operative and post-operative DOSS (dysphagia outcome and severity scale) scores were 4.4 and 3.9, respectively.
authors.affiliation: a 1 Institut Universitaire de la Face et du Cou , Nice, France.
authors.forename: Dorian
authors.initials: D
authors.lastname: Culié
authors.affiliation: b 2 Department of Radiotherapy, Centre Antoine Lacassagne , Nice, France.
authors.forename: Karen
authors.initials: K
authors.lastname: Benezery
authors.affiliation: c 3 Department of Statistics, Centre Antoine Lacassagne , Nice, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Chamorey
authors.affiliation: c 3 Department of Statistics, Centre Antoine Lacassagne , Nice, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Ettaiche
authors.affiliation: a 1 Institut Universitaire de la Face et du Cou , Nice, France.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Fernandez
authors.affiliation: a 1 Institut Universitaire de la Face et du Cou , Nice, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Poissonnet
authors.affiliation: a 1 Institut Universitaire de la Face et du Cou , Nice, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Riss
authors.affiliation: b 2 Department of Radiotherapy, Centre Antoine Lacassagne , Nice, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Hannoun-Lévi
authors.affiliation: b 2 Department of Radiotherapy, Centre Antoine Lacassagne , Nice, France.
authors.forename: Marie-Eve
authors.initials: ME
authors.lastname: Chand
authors.affiliation: b 2 Department of Radiotherapy, Centre Antoine Lacassagne , Nice, France.
authors.forename: Axel
authors.initials: A
authors.lastname: Leysalle
authors.affiliation: d 4 Department of Medical Oncology, Centre Antoine Lacassagne , Nice, France.
authors.forename: Esma
authors.initials: E
authors.lastname: Saada
authors.affiliation: e 5 Department of Pathology, Centre Antoine Lacassagne , Nice, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Sudaka
authors.affiliation: e 5 Department of Pathology, Centre Antoine Lacassagne , Nice, France.
authors.forename: Juliette
authors.initials: J
authors.lastname: Haudebourg
authors.affiliation: a 1 Institut Universitaire de la Face et du Cou , Nice, France.
authors.forename: François
authors.initials: F
authors.lastname: Demard
authors.affiliation: a 1 Institut Universitaire de la Face et du Cou , Nice, France.
authors.forename: José
authors.initials: J
authors.lastname: Santini
authors.affiliation: d 4 Department of Medical Oncology, Centre Antoine Lacassagne , Nice, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Peyrade
authors.affiliation: a 1 Institut Universitaire de la Face et du Cou , Nice, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Dassonville
authors.affiliation: a 1 Institut Universitaire de la Face et du Cou , Nice, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Bozec
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D007825:Laryngectomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D009959:Oropharyngeal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
keywords: head and neck cancer; oropharynx; radiotherapy; recurrence; salvage surgery; squamous cell carcinoma