Postoperative and Functional Outcomes of Oropharyngectomy in Irradiated Neck for Recurrent or Metachronous Squamous Cell Carcinoma.

Abstract

To evaluate predictors of postoperative and functional outcomes following salvage oropharyngectomy. In this single-center retrospective study, we included all patients who underwent an oropharyngectomy in an irradiated neck for recurrent or metachronous cancer between 2014 and 2023. We included 94 patients. The rate of complications was 53.2%, and was associated in multivariable analysis with tumor involving the midline (p = 0.001), oral cavity (p = 0.017) or glossotonsillar sulcus (p = 0.037), transcervical approach (p = 0.004), and high body mass index (p = 0.011). In multivariable analysis, high body mass index (p = 0.023), midline-crossing tumor (p = 0.022), and older age (p = 0.061) were associated with a hospital stay longer than 21 days. After a median follow-up of 74.3 months, 59.6% of patients had a gastrostomy. Predictors for this dependency in multivariable analysis were T3/T4 tumors (p = 0.06) and p16-status (p = 0.079). Salvage oropharyngectomy in irradiated neck remains associated with a complex postoperative course and a high morbidity.