Salvage surgery for head and neck squamous cell carcinoma

Mandapathil, Magis; Roessler, Marion; Werner, Jochen A.; Silver, Carl E.; Rinaldo, Alessandra; Ferlito, Alfio

doi:10.1007/s00405-014-3043-1

Cited by 14 publications

(7 citation statements)

References 45 publications

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“…Although studies by Bachar GY et al and Goodwin et al maintain that salvage surgery controls disease long-term [ 30 , 31 ], other sources emphasize that these procedures (especially laryngectomy) are associated with high morbidity rates and poor overall or disease-specific survival [ 32 , 33 ]. Higher rates of complications and impaired quality of life after salvage surgery have the potential to overshadow any theoretical gains [ 7 , 32 , 33 ]. Proper clinical selection of candidate for salvage surgery is therefore paramount.…”

Section: Discussionmentioning

confidence: 99%

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Predictive and prognostic value of PET/CT imaging post-chemoradiotherapy and clinical decision-making consequences in locally advanced head & neck squamous cell carcinoma: a retrospective study

et al. 2016

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BackgroundThe accuracy of 18F-fluorodeoxygluocose positron emission tomography/computed tomography (PET/CT) in predicting immediate failure after radical chemoradiotherapy (CRT) for HNSCC is poorly characterized at present. The purpose of this study was to examine PET/CT as a predictive and prognostic gauge of immediate failure after CRT and determine the impact of these studies on clinical decision making in terms of salvage surgery.MethodsMedical records of 78 consecutive patients receiving radical CRT for locally advanced HNSCC were reviewed, analyzing PET/CTs done before and 3 months after CRT. Immediate failure was defined as residual disease or locoregional and/or systemic relapse within 6 months after CRT.ResultsMaximum standard uptake value (SUV) of post CRT PET/CT (postSUVmax) was found optimal for predicting immediate failure at a cutpoint of 4.4. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were 90.0 %, 83.8 %, 98.3 %, and 45.0 %, respectively. Of 78 patients studied, postSUVmax ≥4.4 prevailed in 20 (25.6 %), with postSUVmax <4.4 in 58 (74.4 %). At postSUVmax ≥4.4 (vs. postSUVmax <4.4) OS was poorer by comparison (3-year OS: 56.9 vs. 87.7 %; P = 0.005), as was progression-free survival (3-year PFS: 42.9 vs. 81.1 %; P < 0.001). At postSUVmax ≥4.4, OS with and without immediate salvage surgery did not differ significantly (3-year OS: 60.0 vs. 55.6 %; Log-rank P = 0.913).ConclusionPost CRT PET/CT imaging has prognostic value in terms of OS and PFS and is useful in predicting immediate therapeutic failure, given its high NPV. However, OS was not significantly altered by early salvage surgery done on the basis of post CRT PET/CT findings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2147-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

“…Salvage surgery is considered the most curative intervention for residual or recurrent disease in the aftermath of definitive CRT [ 7 ]. However, given the functional disability that generally results, selecting candidates appropriate for salvage surgery is often difficult.…”

Section: Introductionmentioning

confidence: 99%

Predictive and prognostic value of PET/CT imaging post-chemoradiotherapy and clinical decision-making consequences in locally advanced head & neck squamous cell carcinoma: a retrospective study

et al. 2016

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“…Besides, the MR technique is useful for cases wherein the tumor has an atypical shape, which should be paid attention to ensure a sufficient margin, and cases with an atypical anatomy (eg, anatomical anomaly or postoperative change) because the resection of such tumors needs an atypical dissection line. In addition, the technique is equally helpful for salvage surgery for a recurrent case after initial therapy, such as surgery or radiation, since it is difficult to dissect the tissue and understand the tumor location because of the postoperative adhesion or post irradiation‐fibrosis 12,13 . In summary, the MR technique may help otolaryngology surgeons in cases: (a) wherein the tumor is difficult to locate for surgical approach; (b) with an atypical anatomy or tumor shape; and (c) with a recurrent tumor after initial surgery or radiation.…”

Section: Discussionmentioning

confidence: 99%

Case‐specific three‐dimensional hologram with a mixed reality technique for tumor resection in otolaryngology

Mitani

Sato

Kawaguchi

et al. 2021

Laryngoscope Investig Oto

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Objective We report our first experience of using a case‐specific three‐dimensional (3D) hologram for tumor resection in otolaryngology to show the proof of concept. In addition, a questionnaire was administered to assess the usefulness of the mixed reality technique in otolaryngology. Methods A case‐specific 3D hologram was developed from enhanced images of dynamic computed tomography, with reference to contrast‐enhanced magnetic resonance images, and used for preoperative planning and intraoperative image reference. To evaluate the usefulness of the 3D hologram with head mount displays (HMDs), 18 attendings and resident otolaryngologists completed a questionnaire with the Likert scale. Results The case‐specific 3D hologram on HMDs was successfully used by means of easy gesture‐handling without any monitors preoperatively and intraoperatively. The experience of picturing the tumor localization and evaluating the surgical approach was statistically better using the 3D hologram on HMDs than using the computer images (P < .01). Similarly, the holograms were observed to be better for intraoperative application and surgical education than computer images (P < .01). Conclusion We demonstrated the use of a case‐specific 3D hologram for tumor resection in otolaryngology. The technology may be useful for preoperative planning and intraoperative image reference, especially for challenging cases, and surgical education. Level of Evidence NA.

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“…La afectación ganglionar cervical metastásica constituye el principal factor pronóstico en estos pacientes; de ahí surge la necesidad de su control durante el tratamiento quimioradioterápico y el seguimiento posterior [2][3][4][5]. La cirugía de rescate se considera la intervención más curativa para la enfermedad residual o recurrente tras la quimiorradioterapia [6,7]; sin embargo, la selección de los pacientes candidatos es a menudo difícil. Además, las indicaciones y los beneficios en cuanto a la supervivencia son todavía anecdóticos por la limitada evidencia.…”

Section: Discussionunclassified

Enfermedad ganglionar residual tras quimiorradioterapia con intención radical en pacientes con tumores de faringolaringe

et al. 2017

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Salvage surgery for head and neck squamous cell carcinoma

Cited by 14 publications

References 45 publications

Predictive and prognostic value of PET/CT imaging post-chemoradiotherapy and clinical decision-making consequences in locally advanced head & neck squamous cell carcinoma: a retrospective study

Predictive and prognostic value of PET/CT imaging post-chemoradiotherapy and clinical decision-making consequences in locally advanced head & neck squamous cell carcinoma: a retrospective study

Case‐specific three‐dimensional hologram with a mixed reality technique for tumor resection in otolaryngology

Enfermedad ganglionar residual tras quimiorradioterapia con intención radical en pacientes con tumores de faringolaringe

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