Salvage surgery for recurrent neck carcinoma after multimodality therapy

✍ Scribed by Urken, Mark ;Biller, Hugh F. ;Lawson, William ;Haimov, Moshe

• Publisher: Wiley (John Wiley & Sons)
• Year: 1986
• Weight: 941 KB
• Volume: 8
• Category: Article
• ISSN: 0148-6403
• DOI: 10.1002/hed.2890080504

✦ Synopsis

Recurrent carcinoma of the neck after treatment by radical neck dissection and radiotherapy leads to a progressive downhill course if no further therapy is instituted. Nine such patients having fixed, recurrent neck tumors with carotid artery involvement underwent 10 salvage procedures with carotid artery resection and replacement. One patient developed a transient hemiparesis that resolved in 3 days, and in another, a permanent hemiparesis occurred. Three patients have survived longer than 12 months. One patient is free of disease at 42 months following two salvage operations. We attribute the low operative morbidity to the frequent use of the subclavian artery for proximal anastomosis and myocutaneous flaps to resurface cutaneous and mucosal defects. We conclude that salvage surgery with carotid artery replacement can be performed on selected patients who have failed combined therapy as a palliative and possibly curative mea-

sure. HEAD & NECK SURGERY 8:332-342 1986

Before one decides what constitutes a radical procedure, it is necessary to bear in mind that very often the first treatment of cancer is an "all or nothing" affair. Either the growth is completely removed with all its metastases, or the patient's