ABSTRACT
INTRODUCTION: For most patients with squamous head and neck cancer (HN-SCC), locoregional tumour recurrence (TR) carries an extremely poor prognosis and is therapeutically challenging. OBJECTIVE: To define the clinical aspects of TR and their implication on the survival in patients with HN-SCC. PATIENTS AND METHOD: The clinical management and the outcome of 652 patients with HN-SCC were reviewed. RESULTS: The overall incidence of TR in this series of HN-SCC was 19.9% (n=130). The most frequent locations of the primary cancers were oropharynx (32%), hypopharynx (24%), and oral cavity (21%). The rates of recurrence were locoregional 50%, local 43 % and stomal recurrence 7%. The appearance of a TR reduces the overall survival of patients with HN-SCC to 15%. Survival is better in glottic (38%) and supraglottic (27%), carcinomas, and worse in oro-hypopharynx tumours (2-4%). CONCLUSIONS: RT are more frequent in pharyngeal tumours, especially locoregional recurrences. Patients with recurrence in pharynx were definitely associated with poor prognosis and in these cases salvage surgery seems not to improve survival rates.
Subject(s)
Carcinoma, Squamous Cell/pathology , Head and Neck Neoplasms/pathology , Adult , Aged , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/mortality , Female , Head and Neck Neoplasms/diagnosis , Head and Neck Neoplasms/mortality , Humans , Male , Middle Aged , Neoplasm Recurrence, Local , Retrospective Studies , Survival RateABSTRACT
Introducción: Las recidivas tumorales (RT) causan elevada mortalidad en los pacientes con cáncer escamoso de cabeza y cuello (CECC) y complican mucho la actitud terapéutica. Objetivo: Describir los aspectos clínicos de las RT y su implicación en la supervivencia. Pacientes y método: Se revisa a 652 pacientes con CECC y se recoge las características clínicas de las RT observadas. Resultados: Las RT se presentaron en el 19,9 % (130 pacientes) de nuestra serie de CECC. Las localizaciones más frecuentes son mesofaringe (32 %), hipofaringe (24 %) y cavidad oral (21 %). El 50 % de las RT son de carácter locorregional; el 43 %, locales, y el 7 %, estomales. La aparición de una RT reduce al 15 % la supervivencia general de los pacientes con CECC, es mayor en la laringe glótica (38 %) y la supraglótica (27 %), y baja al 2-4 % en mesofaringe e hipofaringe. Conclusiones: Las RT son más frecuentes en tumores faríngeos y de tipo locorregional. El pronóstico en esta localización es muy malo y el tratamiento de rescate apenas modifica la supervivencia
Introduction: For most patients with squamous head and neck cancer (HN-SCC), locoregional tumour recurrence (TR) carries an extremely poor prognosis and is therapeutically challenging. Objective: To define the clinical aspects of TR and their implication on the survival in patients with HN-SCC. Patients and method: The clinical management and the outcome of 652 patients with HN-SCC were reviewed. Results: The overall incidence of TR in this series of HN-SCC was 19.9 % (n=130). The most frequent locations of the primary cancers were oropharynx (32 %), hypopharynx (24 %), and oral cavity (21 %). The rates of recurrence were locoregional 50 %, local 43 % and stomal recurrence 7 %. The appearance of a TR reduces the overall survival of patients with HN-SCC to 15 %. Survival is better in glottic (38 %) and supraglottic (27 %), carcinomas, and worse in oro-hypopharynx tumours (2-4 %). Conclusions: RT are more frequent in pharyngeal tumours, especially locoregional recurrences. Patients with recurrence in pharynx were definitely associated with poor prognosis and in these cases salvage surgery seems not to improve survival rates
