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Abstract

Short CommunicationJ Otolaryngol ENT Res 2017, 7(6): 00229 treatment options including supportive therapy. Literature regarding this topic is not extensive considering the fact that a significant number of squamous cell cancers of the head and neck recur. This is also rarely covered in conferences and major medical meetings as well. Head and neck cancer recurrence can be quite devastating to the patients and their families. Around 50 to 60% of stage III and IV head and neck cancers recur, which makes it more or less common condition faced by head and neck oncologic specialists [1,2]. The survival rate ranges between 15 and 40%. Survival time after local and regional recurrence is 6 to 9 months and 60% are due to local and regional recurrence [3,4]. 90% of the patients with metastases die from uncontrolled disease on the primary site or the neck [4].Old recurrent head and neck cancers present at an advanced stage with poor prognosis. As an example, recurrent early laryngeal cancers such as T1 and T2 vocal fold squamous cell carcinomas have a favorable survival rate if discovered early and treated appropriately (85-95%). More advanced cancers of the larynx, recurrent oropharyngeal cancers, nasopharyngeal and hypopharyngeal cancers have a lower survival rate.The goals of treatment include the following: Figure 1, the modality of choice for treating recurrent head and neck squamous cell carcinoma is usually complete surgical resection. The decision to operate on patients with advanced complex tumors requires thorough planning in the context of a multidisciplinary medical team that includes otolaryngologists, reconstructive surgeons, medical oncologists, radiation oncologists, speech/swallowing therapists, psychologists, pathologists, radiologists and others. In this decision analysis tree, the first question that we have to ask ourselves is when to say no.