Oncological Outcomes of Salvage Oropharyngectomy in Irradiated Neck for Recurrent or Metachronous Squamous Cell Carcinoma

OBJECTIVE: To evaluate oncological outcomes and their predictors following salvage oropharyngectomy. METHODS: This single-center retrospective study included patients who underwent a salvage oropharyngectomy in an irradiated neck for recurrent or metachronous oropharyngeal squamous cell carcinoma (OPSCC) between 2014 and 2023. RESULTS: Ninety-four patients were included. Five-year overall survival (OS), disease-specific survival (DSS), and local recurrence-free survival (LRFS) were 31.7%, 58.5%, and 55.2%, respectively. In multivariable analysis, pN+ status (HR 2.32; p = 0.031), pT status ≥ 3 (HR 2.03; p = 0.020), and age (HR 1.05; p = 0.014) were associated with OS. DSS was associated with pT status ≥ 3 (HR 5.24; p < 0.001), metachronous (vs. recurrent) OPSCC (HR 0.32; p = 0.006), and cN+ status (HR 2.31; p = 0.053). LRFS was associated with metachronous OPSCC (HR 0.30; p = 0.002) and pT status ≥ 3 (HR 3.60; p = 0.001). CONCLUSIONS: This last-resort procedure is associated with poor survival outcomes. In this series, patients with p16-positive OPSCC did not fare better than their p16-negative counterparts.