Abstract
Salvage surgery is often the only curative option for locally recurrent advanced carcinomas of the oral cavity. However, postoperative functional and cosmetic disorders are severe, because extended local excision is needed to eradicate the disease. Surgery is followed by radiotherapy with or without chemotherapy when possible; however, the outcome of such salvage surgery is poor.
We considered the indications of salvage surgery for locally recurrent diseases were rT1-4a and some rT4b diseases (with invasion of the masticatory space or lower portion of the pterygoid process), and diseases involving the skull base or internal carotid artery were considered to have no surgical indications.
As for the outcome of salvage surgery for locally recurrent advanced (rT3 and rT4) cases, 9 of 13 cases treated primarily in other hospitals were alive with NED, and 5 of 9 cases treated in our hospital were alive with NED.
An extended local excision usually requires reconstructive surgery. In patients with surgery as the primary treatment, selection of flaps and anastomotic vessels for reconstruction may often be limited. A thorough preoperative treatment plan with informed consent and postoperative supportive care are necessary for salvage surgery of locally recurrent advanced diseases of the oral cavity.
