Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada.
Head Neck. 2011 Apr;33(4):516-24. doi: 10.1002/hed.21480.
The purpose of this study was to evaluate the efficacy of salvage surgery for local recurrences of oropharyngeal squamous cell carcinoma (OPSCC) and identify predictors of survival.
The authors reviewed 264 patients with OPSCC treated with radiation or chemoradiation identified retrospectively. Of the 77 patients that experienced recurrences, 37 had local or local and regional recurrences and were considered for salvage surgery.
Of the 37 patients with local or local and regional recurrence, 5 had unresectable disease whereas 3 refused surgery. The remainder underwent salvage surgery with 2-year and 5-year survival rates of 64.5% and 43.4%, respectively. A history of alcohol abuse and positive surgical margins were the only predictors of poorer overall survival (p < .05) after salvage surgery.
Surgical salvage of locoregional recurrences can be effective if wide resections are performed so that negative margins can be achieved.
本研究旨在评估挽救性手术治疗口咽鳞状细胞癌（OPSCC）局部复发的疗效，并确定生存预测因素。
作者回顾性分析了 264 例接受放疗或放化疗的 OPSCC 患者。在 77 例复发患者中，37 例发生局部或局部和区域复发，并考虑进行挽救性手术。
在 37 例局部或局部和区域复发的患者中，5 例患者疾病无法切除，5 例患者拒绝手术。其余患者接受了挽救性手术，2 年和 5 年的生存率分别为 64.5%和 43.4%。挽救性手术后，只有酗酒史和阳性手术切缘是总生存率较差的唯一预测因素（p <.05）。
如果能进行广泛切除以获得阴性切缘，则局部区域复发的手术挽救是有效的。
