Surgical Management of Recurrent Disease

Abstract

Appropriate surgery, followed by radiotherapy when needed, represents the best therapeutic approach to prevent the recurrences of the disease. Tumor size (cT3/cT4), tumors with high-grade histology, lymph node metastases, extraparenchymal extension, neural invasion, lymphatic or vascular invasion, and close (<1 mm) or positive resection margins lead to a worse prognosis and to a high risk of local recurrence. Patterns of recurrence are heterogeneous. Histological confirmation and a complete restaging of the disease including a head and neck MRI and a total body CT scan should be always advised before planning surgery for local/regional recurrences. An aggressive treatment including surgery is oncologically sound with a 5-year disease-free survival of 64.1%.