Special Considerations: Previously Treated Patients
Recurrent cancers pose unique challenges, and all patients must be thoroughly evaluated for disease-related factors as well as factors related to details of previous treatment.
In general, a low disease-free interval following apparently adequate treatment portends adversely. The details of previous treatment, whether surgery alone or in combination with radiation and chemotherapy, significantly influence the local milieu and the anticipated difficulties in finding suitable tissue planes and recipients where needed.
All factors must be carefully weighed prior to embarking upon an ambitious salvage attempt, and the patient and family counseled at length about the anticipated risks and complications.