title: Salvage Transoral Videolaryngoscopic Surgery for radiorecurrent hypopharyngeal and supraglottic cancer.
abstract: OBJECTIVE
  To evaluate the feasibility of Transoral Videolaryngoscopic Surgery (TOVS) for radiorecurrent supraglottic and hypopharyngeal cancer, and to compare survival and complications between primary and radiorecurrent cases.
  
  
  METHODS
  Twelve cases of salvage TOVS for radiorecurrent cancer and 53 cases of TOVS as an initial treatment (primary cases) were evaluated. Days to resume soft diet, Functional Outcomes of Swallowing Scale (FOSS), postoperative complications, epithelization days and survival outcomes were assessed by retrospective chart review.
  
  
  RESULTS
  FOSS score was significantly worse in salvage cases compared with primary cases. Bleeding and airway compromise was slightly greater in salvage cases than in primary cases; however, this was not statistically significant. Wound healing was significantly delayed in salvage cases compared with primary cases (P<0.001). In primary cases, wounds were re-epithelized within 60 days in 83% of patients and within 90 days in almost all patients, while in salvage cases 42% of patients required more than 90 days for wound healing. In salvage cases, the 5-year overall survival, disease specific survival rate, local control rate, and laryngeal preservation rate was 85.7%, 85.7%, 62.5%, and 78.0%, respectively, and 85.7%, 98.0%, 91.3%, and 97.8%, respectively, for primary cases. Local control rate was significantly better in primary cases than in salvage cases.
  
  
  CONCLUSIONS
  Salvage TOVS was feasible in highly selected cases. After serial transoral surgery, the final laryngeal preservation rate was satisfactory. Swallowing function in salvage cases tended to be worse than in primary cases, and a significantly longer time was required for wound healing.
authors.affiliation: National Defense Medical College, Department of Otolaryngology - Head and Neck Surgery, Saitama, Japan. Electronic address: tomifuji@ndmc.ac.jp.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Tomifuji
authors.affiliation: National Defense Medical College, Department of Otolaryngology - Head and Neck Surgery, Saitama, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Araki
authors.affiliation: Kitasato University School of Medicine, Department of Otorhinolaryngology - Head and Neck Surgery, Kanagawa, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Yamashita
authors.affiliation: National Defense Medical College, Department of Otolaryngology - Head and Neck Surgery, Saitama, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Shiotani
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D059248:Chemoradiotherapy; D003679:Deglutition; D003680:Deglutition Disorders / Q000453:epidemiology / Q000503:physiopathology; D005240:Feasibility Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery* / Q000628:therapy; D007822:Laryngeal Neoplasms / Q000601:surgery* / Q000628:therapy; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011878:Radiotherapy; D016879:Salvage Therapy; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate
keywords: Chemoradiation; Radiation; Salvage transoral surgery; Transoral Videolaryngoscopic Surgery (TOVS); Wound healing