Implications of head and neck cancer treatment failure in the neck.

OBJECTIVE

Study the survival of patients with cervical lymphatic squamous cell carcinoma recurrence.

STUDY DESIGN

Review of tumor registry database.

SETTING

Academic health science center.

SUBJECTS AND METHODS

Forty-seven isolated neck recurrence patients identified from 224 recurrences from a total of 1291 patients treated between 1998 and 2007. The main outcome measurements were neck lymph nodal recurrence, treatment-specific survival, and overall survival.

RESULTS

A total of 47 patients had neck recurrence; 10 of the neck recurrence patients (21.3%) had regional disease (N+) at initial presentation. Median survival for patients with neck recurrence was 14.7 months (95% confidence interval [CI] 8.6-18.1 mo), and five-year survival for this group was five percent (95% CI 0%-30%). Neck dissection salvage therapy for neck recurrence resulted in the best survival.

CONCLUSION

Neck dissection as a salvage therapy for neck recurrence resulted in the best survival, and there was no survival benefit in terms of whether a patient had a neck dissection or not as his or her initial therapy.