Salvage surgery after concomitant chemoradiation in head and neck squamous cell carcinomas - stratification for postsalvage survival.

BACKGROUND Salvage surgery after concomitant chemoradiation therapy (CCRT) for patients with head and neck squamous cell carcinomas (HNSCC) is challenging because of its associated morbidity/mortality and the poor prognoses of these patients. METHODS The outcome analysis of prospectively collected data from 93 patients with HNSCC with local and/or regional shows treatment failures but without distant metastasis after CCRT. RESULTS Thirty-eight patients underwent salvage surgery, whereas 55 underwent palliative treatment, with 2-year overall survival rates of 43.4% and 0%, respectively. Initial stage IV tumors (p = .017) and concurrent local and regional failures (p = .003) were independent predictors for decreased survival after salvage surgery. Two-year overall survival rates for patients with 2, 1, or none of these predictive factors were 0%, 49%, and 83%, respectively (p = .0005). CONCLUSION Salvage surgery after CCRT has acceptable outcomes. Initial stage IV tumors and concurrent local and regional failures were independent predictors that can stratify patients into distinct prognostic groups for postsalvage survival.