title: Efficacy, outcomes, and complication rates of different surgical and nonsurgical treatment modalities for recurrent/residual oropharyngeal carcinoma: A systematic review and meta-analysis.
abstract: Treatment of recurrent oropharyngeal cancer is widely thought to have poor outcomes. Justification for treatment, especially in advanced cases, can be difficult.
  
  
  
  A systematic search of MEDLINE, Embase, and Cochrane databases was conducted. Included studies reported specific recurrent oropharyngeal cancer survival data.
  
  
  
  Twenty-two retrospective studies were included. Pooled 3-year overall survival (OS) was 26% (95% confidence interval [CI] = 22% to 29%; I squared = 40.7%; p = .057). Pooled 5-year OS was 23% (95% CI = 20% to 27%; I squared = 73.9%; p = .000). Surgical treatment was superior to radiation (5-year OS 26% vs 16%, respectively; p < .001). The 5-year OS improved over time: 18% in the pre-2000 cohort; 35% in the mixed pre-2000 and post-2000 group; and 51% in the post-2000 cohort (p < .001).
  
  
  
  Outcomes have improved considerably over the last 2 decades, resulting in approximately 50% overall 5-year survival. Human papillomavirus (HPV) status, patient selection, and improvements in care may explain this. © 2016 The Authors Head & Neck Published by Wiley Periodicals, Inc. Head Neck, 2016 © 2016 Wiley Periodicals, Inc. Head Neck 38: 1855-1861, 2016.
authors.affiliation: Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, West Midlands, United Kingdom.
authors.forename: Sharan Chakkyath
authors.initials: SC
authors.lastname: Jayaram
authors.affiliation: Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, West Midlands, United Kingdom.
authors.forename: Sayed Jameel
authors.identifier: 0000-0003-3065-0269
authors.initials: SJ
authors.lastname: Muzaffar
authors.affiliation: Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, West Midlands, United Kingdom.
authors.forename: Ikhlaaq
authors.initials: I
authors.lastname: Ahmed
authors.affiliation: Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, West Midlands, United Kingdom.
authors.forename: Jagtar
authors.initials: J
authors.lastname: Dhanda
authors.affiliation: Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, West Midlands, United Kingdom.
authors.forename: Vinidh
authors.initials: V
authors.lastname: Paleri
authors.affiliation: Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, West Midlands, United Kingdom.
authors.forename: Hisham
authors.initials: H
authors.lastname: Mehanna
mesh_terms: D059248:Chemoradiotherapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018365:Neoplasm, Residual / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D010611:Pharyngectomy / Q000379:methods; D011379:Prognosis; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: cancer; malignancy; oropharynx; radiotherapy; surgery