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Salvage surgery in head and neck cancer: External validation of predictors of disease-specific survival.
Oral Oncol. 2020 Jun 29; 109:104876.OO

Abstract

OBJECTIVE

Salvage surgery in recurrent head and neck squamous cell carcinoma (HNSCC) is associated with poor outcomes. There is great interest to better identify suitable surgical patients. This study aimed to validate the proposal of Hamoir et al. to use three items to predict the outcomes of salvage surgery.

MATERIALS AND METHODS

Single-center analysis of 577 patients undergoing salvage surgery for recurrent HNSCC during the period 1985-2016, with a minimal follow-up of 2 years. Patients were classified according to the prediction modeling proposed by Hamoir et al. This prediction modeling is based on three predictors: the tumor site (larynx vs non-larynx), initial staging (stage I-II vs stage III-IV), and site of recurrence (local or regional vs locoregional).

RESULTS

Five-year disease-specific survival after salvage surgery was 54.0% (95% CI: 49.6-58.4%). Applying the prediction modeling tested, a total of 212 patients (36.7%) patients had no predictors of poor prognosis, 185 (32.1%) had one predictor, 146 (25.3%) two predictors, and 34 (5.9%) three predictors. Five-year disease-specific survival for patients with none, one, two and three predictors were 82.2%, 47.2%, 29.5% and 20.2% respectively (P = 0.0001).

CONCLUSIONS

We have validated the prediction modeling based on the location of the tumor, initial staging and locoregional recurrence proposed by Hamoir et al. This prediction model is easy to apply and provides good information about the possibilities of success of salvage surgery.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, University Hospital de la Santa Creu i Sant Pau, Universitat Autonòma de Barcelona, Barcelona, Spain. Electronic address: mquer@santpau.cat.Department of Otolaryngology-Head and Neck Surgery, University Hospital de la Santa Creu i Sant Pau, Universitat Autonòma de Barcelona, Barcelona, Spain; Oncogenesis and Antitumor Drugs Group, Biomedical Research Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.Department of Otolaryngology-Head and Neck Surgery, University Hospital de la Santa Creu i Sant Pau, Universitat Autonòma de Barcelona, Barcelona, Spain.Department of Otolaryngology-Head and Neck Surgery, University Hospital de la Santa Creu i Sant Pau, Universitat Autonòma de Barcelona, Barcelona, Spain.Department of Otolaryngology-Head and Neck Surgery, University Hospital de la Santa Creu i Sant Pau, Universitat Autonòma de Barcelona, Barcelona, Spain.Department of Otolaryngology-Head and Neck Surgery, University Hospital de la Santa Creu i Sant Pau, Universitat Autonòma de Barcelona, Barcelona, Spain.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32615457

Citation

Quer, Miquel, et al. "Salvage Surgery in Head and Neck Cancer: External Validation of Predictors of Disease-specific Survival." Oral Oncology, vol. 109, 2020, p. 104876.
Quer M, León X, Casasayas M, et al. Salvage surgery in head and neck cancer: External validation of predictors of disease-specific survival. Oral Oncol. 2020;109:104876.
Quer, M., León, X., Casasayas, M., Sansa, A., López, M., & García Lorenzo, J. (2020). Salvage surgery in head and neck cancer: External validation of predictors of disease-specific survival. Oral Oncology, 109, 104876. https://doi.org/10.1016/j.oraloncology.2020.104876
Quer M, et al. Salvage Surgery in Head and Neck Cancer: External Validation of Predictors of Disease-specific Survival. Oral Oncol. 2020 Jun 29;109:104876. PubMed PMID: 32615457.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Salvage surgery in head and neck cancer: External validation of predictors of disease-specific survival. AU - Quer,Miquel, AU - León,Xavier, AU - Casasayas,Maria, AU - Sansa,Aina, AU - López,Montserrat, AU - García Lorenzo,Jacinto, Y1 - 2020/06/29/ PY - 2020/05/04/received PY - 2020/06/22/revised PY - 2020/06/22/accepted PY - 2020/7/3/pubmed PY - 2020/7/3/medline PY - 2020/7/3/entrez SP - 104876 EP - 104876 JF - Oral oncology JO - Oral Oncol. VL - 109 N2 - OBJECTIVE: Salvage surgery in recurrent head and neck squamous cell carcinoma (HNSCC) is associated with poor outcomes. There is great interest to better identify suitable surgical patients. This study aimed to validate the proposal of Hamoir et al. to use three items to predict the outcomes of salvage surgery. MATERIALS AND METHODS: Single-center analysis of 577 patients undergoing salvage surgery for recurrent HNSCC during the period 1985-2016, with a minimal follow-up of 2 years. Patients were classified according to the prediction modeling proposed by Hamoir et al. This prediction modeling is based on three predictors: the tumor site (larynx vs non-larynx), initial staging (stage I-II vs stage III-IV), and site of recurrence (local or regional vs locoregional). RESULTS: Five-year disease-specific survival after salvage surgery was 54.0% (95% CI: 49.6-58.4%). Applying the prediction modeling tested, a total of 212 patients (36.7%) patients had no predictors of poor prognosis, 185 (32.1%) had one predictor, 146 (25.3%) two predictors, and 34 (5.9%) three predictors. Five-year disease-specific survival for patients with none, one, two and three predictors were 82.2%, 47.2%, 29.5% and 20.2% respectively (P = 0.0001). CONCLUSIONS: We have validated the prediction modeling based on the location of the tumor, initial staging and locoregional recurrence proposed by Hamoir et al. This prediction model is easy to apply and provides good information about the possibilities of success of salvage surgery. SN - 1879-0593 UR - https://www.unboundmedicine.com/medline/citation/32615457/Salvage_surgery_in_head_and_neck_cancer:_External_validation_of_predictors_of_disease-specific_survival L2 - https://linkinghub.elsevier.com/retrieve/pii/S1368-8375(20)30312-2 DB - PRIME DP - Unbound Medicine ER -
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