Survival of patients who needed salvage surgery for recurrence after radiotherapy for oral carcinoma

Objective: To find out how long patients with oral carcinoma survived after the primary tumour had been treated by radiotherapy and who required salvage surgery for recurrence; to see if there were any significant differences in age, sex, site, size, and histology of the tumours in relation to survival; and to see if the time of the recurrence had any effect on the survival. Design: Retrospective analysis of case notes. Setting: Teaching Hospital, Scotland. Subjects: 370 consecutive patients, 187 (51%) of whom were initially treated by radiotherapy; 58 of the 187 (31%) developed a recurrence that was considered suitable for salvage surgery. Results and conclusions: 43/58 patients had died and 15 patients were still alive at the time of the study, the median (range) survival of the groups was 21 (6–89) months compared with 72 (19–212) months, respectively (P = 0.0001). Other significant differences included age at presentation for men (P = 0.004), and the increased likelihood of survival if the initial site of the tumour was the tongue (P = 0.02). There was also a highly significant correlation between time to recurrence and survival amongst those who died (P = 0.002). A short recurrence time may suggest a less radical surgical salvage option if reduced survival is likely. Why there should be such an association is unknown.