Head and Neck Surgery Department, Hospital Aristides Maltez, Salvador, Brazil.
Head Neck. 2010 Aug;32(8):997-1002. doi: 10.1002/hed.21298.
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).
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.
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).
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.
挽救性手术被认为是复发性口腔癌患者的最佳治疗方法。不幸的是，50%至 60%接受挽救性手术的患者将进一步出现局部区域复发，通常不考虑对这些患者进行进一步治疗。本研究旨在报告我们对再次出现口腔和口咽鳞状细胞癌（SCC）复发性患者进行第二次挽救性手术的经验。
41 例患者接受了第二次挽救性手术，目的是治愈复发性口腔癌。34 例患者采用广泛局部切除术，9 例患者行颈清扫术，7 例患者行单纯颈清扫术。
3 年癌症特异性生存率（CSS）为 20%。复发时间<6 个月的患者 3 年 CSS 为零，而复发时间>6 个月的患者 3 年 CSS 为 32.3%（p =.007）。
第二次挽救性手术可被视为治疗复发性口腔 SCC 患者的一种潜在治愈性治疗方法。无病间隔是与预后相关的主要临床因素。
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