{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:59:35Z","timestamp":1792803575215,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,12,11]],"date-time":"2018-12-11T00:00:00Z","timestamp":1544486400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Most studies that report on salvage surgery after primary radiotherapy for head and neck squamous cell carcinoma (HNSCC) are small and heterogeneous. Subsequently, some relevant questions remain unanswered. We specifically focused on (1) difference in prognosis per tumor subsite, corrected for disease stage, and (2) differences in prognosis after salvage surgery for local, regional, and locoregional recurrences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Single\u2010center study (2000\u20102016).<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Patients treated with salvage surgery for HNSCC recurrence after (chemo)radiotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 189 patients were included. Five\u2010year overall survival (OS) was 33%, and median OS was 18 (95% confidence interval [CI], 11\u201026) months. Treatment\u2010related mortality was 2%. Larynx carcinoma was associated with more favorable local (adjusted hazard ratio [HR] = 4.02; 95% CI, 1.46\u201011.10; <jats:italic>P<\/jats:italic> =. 007) and locoregional control (adjusted HR = 5.34; 95% CI, 1.83\u201015.61; <jats:italic>P<\/jats:italic> =. 002) than pharyngeal carcinoma. American Society of Anesthesiologists (ASA) score (\u22653 vs 1\u20102: adjusted HR = 3.04; 95% CI, 1.17\u20107.91; <jats:italic>P<\/jats:italic> =. 023), pT stage (3\u20104 vs 1\u20102: adjusted HR = 4.41; 95% CI, 1.65\u201011.82; <jats:italic>P<\/jats:italic> =. 003), and salvage surgery for locoregional recurrences (locoregional vs local: adjusted HR = 3.81; 95% CI, 1.13\u201011.82; <jats:italic>P<\/jats:italic> =. 021) were independent predictors for disease\u2010free survival (DFS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Salvage surgery for larynx carcinoma, regardless of disease stage and other prognostic factors, results in more favorable loco(regional) control but not favorable DFS than pharyngeal carcinoma. The observed difference in DFS between salvage surgery for local and regional recurrences was not significant after correction for confounders. However, survival following salvage surgery for locoregional disease is significantly worse. For this subgroup, we propose to consider T status and comorbidity for clinical decision making, as high pT stage and ASA score are independent predictors for worse DFS.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599818818443","type":"journal-article","created":{"date-parts":[[2018,12,11]],"date-time":"2018-12-11T04:51:42Z","timestamp":1544503902000},"page":"1023-1033","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Salvage Surgery for Recurrence after Radiotherapy for Squamous Cell Carcinoma of the Head and Neck"],"prefix":"10.1002","volume":"160","author":[{"given":"Joris B. W.","family":"Elbers","sequence":"first","affiliation":[{"name":"Department of Head and Neck Oncology and Surgery Netherlands Cancer Institute Amsterdam The Netherlands"},{"name":"Department of Radiation Oncology Netherlands Cancer Institute Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abrahim","family":"Al\u2010Mamgani","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Netherlands Cancer Institute Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel W. M.","family":"van den Brekel","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Oncology and Surgery Netherlands Cancer Institute Amsterdam The Netherlands"},{"name":"Department of Oral and Maxillofacial Surgery Academic Medical Center University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"J\u00f3\u017awiak","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Netherlands Cancer Institute Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. P.","family":"de Boer","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Netherlands Cancer Institute Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J. F. M.","family":"Lohuis","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Oncology and Surgery Netherlands Cancer Institute Amsterdam The Netherlands"},{"name":"Department of Oral and Maxillofacial Surgery Academic Medical Center University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan M.","family":"Willems","sequence":"additional","affiliation":[{"name":"Department of Pathology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Verheij","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Netherlands Cancer Institute Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte L.","family":"Zuur","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Oncology and Surgery Netherlands Cancer Institute Amsterdam The Netherlands"},{"name":"Department of Oral and Maxillofacial Surgery Academic Medical Center University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21254"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2015.07.043"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.5688"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2009.04.014"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e328058670f"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20269"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200003001-00001"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20428"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12726"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.133.6.526"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016480902748520"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.126.12.1473"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20297"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24065"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-009-0946-3"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2014.10.002"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20502"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23781"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2011.02.002"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2011.01.004"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24595"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20309"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20743"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2015.2158"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599818818443","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599818818443","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599818818443","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T13:24:30Z","timestamp":1760966670000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599818818443"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,11]]},"references-count":24,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1177\/0194599818818443"],"URL":"https:\/\/doi.org\/10.1177\/0194599818818443","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,11]]},"assertion":[{"value":"2018-07-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-11-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}