Treatment of locally recurrent squamous cell carcinoma of the head and neck
- Michael T Milano, MD, PhD
Michael T Milano, MD, PhD
- Associate Professor
- Department of Radiation Oncology
- University of Rochester
- Steven J Chmura, MD, PhD
Steven J Chmura, MD, PhD
- Assistant Professor
- University of Chicago
- Daniel J Haraf, MD
Daniel J Haraf, MD
- University of Chicago
- Victoria Banuchi, MD, MPH
Victoria Banuchi, MD, MPH
- Assistant Professor of Otolaryngology
- Weill Cornell Medical College
- Dennis Kraus, MD
Dennis Kraus, MD
- Director, Center for Head and Neck Oncology
- New York Head & Neck Institute
- North Shore-LIJ Health System
- Section Editors
- David M Brizel, MD
David M Brizel, MD
- Section Editor — Radiation Therapy
- Leonard R Prosnitz Professor of Radiation Oncology
- Professor of Otolaryngology Head & Neck Surgery
- Duke University Cancer Institute
- Marvin P Fried, MD, FACS
Marvin P Fried, MD, FACS
- Section Editor — Head and Neck Surgery
- Professor and University Chairman, Department of Otorhinolaryngology - Head and Neck Surgery
- Montefiore Medical Center, Albert Einstein College of Medicine
Recurrent disease is a major cause of morbidity and an obstacle to long-term survival in squamous cell carcinoma of the head and neck. Locoregional recurrences are seen in 15 to 50 percent of patients with squamous cell carcinoma of the head and neck, and this is a major factor contributing to deaths from head and neck cancer [1-3].
Recurrent head and neck cancer is difficult to treat for multiple reasons, including the effects of prior treatment on tumor cells, as well as the infiltrative and multifocal nature that typically characterizes recurrent disease in this area .
The approach to treatment for patients with locally recurrent squamous cell carcinoma of the head and neck will be reviewed here. Recurrent nasopharyngeal cancer and recurrent salivary gland tumors are discussed separately.
- Bourhis J, Le Maître A, Baujat B, et al. Individual patients' data meta-analyses in head and neck cancer. Curr Opin Oncol 2007; 19:188.
- Brockstein B, Haraf DJ, Rademaker AW, et al. Patterns of failure, prognostic factors and survival in locoregionally advanced head and neck cancer treated with concomitant chemoradiotherapy: a 9-year, 337-patient, multi-institutional experience. Ann Oncol 2004; 15:1179.
- Posner MR, Hershock DM, Blajman CR, et al. Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med 2007; 357:1705.
- Ho AS, Kraus DH, Ganly I, et al. Decision making in the management of recurrent head and neck cancer. Head Neck 2014; 36:144.
- Goodwin WJ Jr. Salvage surgery for patients with recurrent squamous cell carcinoma of the upper aerodigestive tract: when do the ends justify the means? Laryngoscope 2000; 110:1.
- Spencer SA, Harris J, Wheeler RH, et al. Final report of RTOG 9610, a multi-institutional trial of reirradiation and chemotherapy for unresectable recurrent squamous cell carcinoma of the head and neck. Head Neck 2008; 30:281.
- Spencer SA, Harris J, Wheeler RH, et al. RTOG 96-10: reirradiation with concurrent hydroxyurea and 5-fluorouracil in patients with squamous cell cancer of the head and neck. Int J Radiat Oncol Biol Phys 2001; 51:1299.
- Wong LY, Wei WI, Lam LK, Yuen AP. Salvage of recurrent head and neck squamous cell carcinoma after primary curative surgery. Head Neck 2003; 25:953.
- Arnold DJ, Goodwin WJ, Weed DT, Civantos FJ. Treatment of recurrent and advanced stage squamous cell carcinoma of the head and neck. Semin Radiat Oncol 2004; 14:190.
- McDonald MW, Lawson J, Garg MK, et al. ACR appropriateness criteria retreatment of recurrent head and neck cancer after prior definitive radiation expert panel on radiation oncology-head and neck cancer. Int J Radiat Oncol Biol Phys 2011; 80:1292.
- Agra IM, Carvalho AL, Pontes E, et al. Postoperative complications after en bloc salvage surgery for head and neck cancer. Arch Otolaryngol Head Neck Surg 2003; 129:1317.
- Lee SC, Shores CG, Weissler MC. Salvage surgery after failed primary concomitant chemoradiation. Curr Opin Otolaryngol Head Neck Surg 2008; 16:135.
- Young VN, Mangus BD, Bumpous JM. Salvage laryngectomy for failed conservative treatment of laryngeal cancer. Laryngoscope 2008; 118:1561.
- Richey LM, Shores CG, George J, et al. The effectiveness of salvage surgery after the failure of primary concomitant chemoradiation in head and neck cancer. Otolaryngol Head Neck Surg 2007; 136:98.
- Kostrzewa JP, Lancaster WP, Iseli TA, et al. Outcomes of salvage surgery with free flap reconstruction for recurrent oral and oropharyngeal cancer. Laryngoscope 2010; 120:267.
- Kim AJ, Suh JD, Sercarz JA, et al. Salvage surgery with free flap reconstruction: factors affecting outcome after treatment of recurrent head and neck squamous carcinoma. Laryngoscope 2007; 117:1019.
- Dubsky PC, Stift A, Rath T, Kornfehl J. Salvage surgery for recurrent carcinoma of the hypopharynx and reconstruction using jejunal free tissue transfer and pectoralis major muscle pedicled flap. Arch Otolaryngol Head Neck Surg 2007; 133:551.
- Zou H, Zhang WF, Han QB, Zhao YF. Salvage reconstruction of extensive recurrent oral cancer defects with the pectoralis major myocutaneous flap. J Oral Maxillofac Surg 2007; 65:1935.
- Head C, Sercarz JA, Abemayor E, et al. Microvascular reconstruction after previous neck dissection. Arch Otolaryngol Head Neck Surg 2002; 128:328.
- Sayles M, Grant DG. Preventing pharyngo-cutaneous fistula in total laryngectomy: a systematic review and meta-analysis. Laryngoscope 2014; 124:1150.
- Johnson A, Grammer T, Medina J. Primary tracheoesophageal puncture in salvage laryngectomy patients. Laryngoscope 2013; 123:1227.
- Ganly I, Patel SG, Matsuo J, et al. Results of surgical salvage after failure of definitive radiation therapy for early-stage squamous cell carcinoma of the glottic larynx. Arch Otolaryngol Head Neck Surg 2006; 132:59.
- Marioni G, Marchese-Ragona R, Lucioni M, Staffieri A. Organ-preservation surgery following failed radiotherapy for laryngeal cancer. Evaluation, patient selection, functional outcome and survival. Curr Opin Otolaryngol Head Neck Surg 2008; 16:141.
- Santoro R, Meccariello G, Mannelli G, et al. Surgical options in radiotherapy-failed early glottic cancer. Eur Arch Otorhinolaryngol 2014; 271:777.
- Li M, Lorenz RR, Khan MJ, et al. Salvage laryngectomy in patients with recurrent laryngeal cancer in the setting of nonoperative treatment failure. Otolaryngol Head Neck Surg 2013; 149:245.
- White H, Ford S, Bush B, et al. Salvage surgery for recurrent cancers of the oropharynx: comparing TORS with standard open surgical approaches. JAMA Otolaryngol Head Neck Surg 2013; 139:773.
- Grant DG, Salassa JR, Hinni ML, et al. Transoral laser microsurgery for recurrent laryngeal and pharyngeal cancer. Otolaryngol Head Neck Surg 2008; 138:606.
- Ramakrishnan Y, Drinnan M, Kwong FN, et al. Oncologic outcomes of transoral laser microsurgery for radiorecurrent laryngeal carcinoma: a systematic review and meta-analysis of English-language literature. Head Neck 2014; 36:280.
- Dagan R, Morris CG, Kirwan JM, et al. Elective neck dissection during salvage surgery for locally recurrent head and neck squamous cell carcinoma after radiotherapy with elective nodal irradiation. Laryngoscope 2010; 120:945.
- Temam S, Koka V, Mamelle G, et al. Treatment of the N0 neck during salvage surgery after radiotherapy of head and neck squamous cell carcinoma. Head Neck 2005; 27:653.
- Farrag TY, Lin FR, Cummings CW, et al. Neck management in patients undergoing postradiotherapy salvage laryngeal surgery for recurrent/persistent laryngeal cancer. Laryngoscope 2006; 116:1864.
- Yao M, Roebuck JC, Holsinger FC, Myers JN. Elective neck dissection during salvage laryngectomy. Am J Otolaryngol 2005; 26:388.
- Koss SL, Russell MD, Leem TH, et al. Occult nodal disease in patients with failed laryngeal preservation undergoing surgical salvage. Laryngoscope 2014; 124:421.
- Lee DJ, Kwon KH, Chung EJ, et al. The role of elective neck dissection during salvage surgery in head and neck squamous cell carcinoma. Acta Otolaryngol 2013; 133:886.
- Chopra S, Gupta T, Agarwal JP, et al. Re-irradiation in the management of isolated neck recurrences: current status and recommendations. Radiother Oncol 2006; 81:1.
- Liauw SL, Amdur RJ, Morris CG, et al. Isolated neck recurrence after definitive radiotherapy for node-positive head and neck cancer: salvage in the dissected or undissected neck. Head Neck 2007; 29:715.
- Mabanta SR, Mendenhall WM, Stringer SP, Cassisi NJ. Salvage treatment for neck recurrence after irradiation alone for head and neck squamous cell carcinoma with clinically positive neck nodes. Head Neck 1999; 21:591.
- Watson JC, Ridge JA. Surgical management of local and regional recurrent head and neck squamous cell carcinoma. Curr Opin Oncol 1998; 10:207.
- Jones AS, Tandon S, Helliwell TR, et al. Survival of patients with neck recurrence following radical neck dissection: utility of a second neck dissection? Head Neck 2008; 30:1514.
- Grandi C, Mingardo M, Guzzo M, et al. Salvage surgery of cervical recurrences after neck dissection or radiotherapy. Head Neck 1993; 15:292.
- Kowalski LP. Results of salvage treatment of the neck in patients with oral cancer. Arch Otolaryngol Head Neck Surg 2002; 128:58.
- Kupferman ME, Morrison WH, Santillan AA, et al. The role of interstitial brachytherapy with salvage surgery for the management of recurrent head and neck cancers. Cancer 2007; 109:2052.
- Bollet MA, Lapeyre M, Marchal C, et al. Cervical lymph node relapses of head-and-neck squamous cell carcinoma: is brachytherapy a therapeutic option? Int J Radiat Oncol Biol Phys 2001; 51:1305.
- Emami B, Bignardi M, Spector GJ, et al. Reirradiation of recurrent head and neck cancers. Laryngoscope 1987; 97:85.
- Janot F, de Raucourt D, Benhamou E, et al. Randomized trial of postoperative reirradiation combined with chemotherapy after salvage surgery compared with salvage surgery alone in head and neck carcinoma. J Clin Oncol 2008; 26:5518.
- GENERAL PRINCIPLES
- Patient selection
- Treatment options
- SALVAGE SURGERY
- Open surgical salvage
- - Complications
- - Advances in reconstructive surgery
- Conservative approaches
- - Partial laryngectomy
- - Transoral robotic surgery
- - Transoral laser microsurgery
- Prophylactic neck dissection
- Isolated neck recurrence
- Postoperative radiation therapy
- PALLIATIVE SYSTEMIC THERAPY
- SUMMARY AND RECOMMENDATIONS