Morbidity of salvage surgery for recurrent oral/oropharyngeal cancers after radiotherapy or chemoradiation

Abstract

BACKGROUND: Oral/oropharyngeal cancer is the eighth most common malignancy worldwide and persists as a serious problem in many regions of the world. With the multidisciplinary treatment of oral/oropharyngeal cancers, the survival rate is increasing in recent years. However, when recurrence after radiotherapy or chemoradiation occurs, the salvage surgery will be very challenging. OBJECTIVES: The aim of this study was to evaluate the morbidity of salvage surgery for recurrent oral/oropharyngeal cancers after radiotherapy or chemoradiation. METHODS: We retrospectively reviewed our cases of recurrent oral/oropharyngeal cancers after radiotherapy or chemoradiation. The patients were treated with salvage surgery and microsurgical reconstruction of the defects with free flaps. FINDINGS: The morbidity rate of salvage surgery was high. The major complications included arterial and venous thrombosis of the flap, flap loss, chyle leak, wound infection, lung infection, delayed healing, wound dehiscence, and common carotid rupture. CONCLUSIONS: Salvage surgery for recurrent oral/oropharyngeal cancers after radiotherapy or chemoradiation is technically challenging. The indication for salvage surgery is still to be determined. More evidences are needed before we can have a final conclusion.