Salvage Surgery for Patients With Recurrent Oral and Oropharyngeal Squamous Cell Carcinoma Involving the Carotid Artery

Abstract

Purpose: Outcomes of salvage surgery and carotid artery (CA) management were evaluated in patients with oral and oropharyngeal cancer.

Patients and methods: Eighteen patients with recurrent oral and oropharyngeal squamous cell carcinoma involving the CA underwent salvage surgeries consisting of wide resection of the tumor, CA resection without and with reconstruction, and CA subadventitial dissection without and with encapsulation. Major tissue defects were reconstructed using a flap.

Results: One patient showed postoperative transient hemiplegia, and wound dehiscence occurred at the recipient site in 2 patients. Two patients had carotid blowout. One patient who underwent CA resection and reconstruction had a carotid embolism. After 5 to 42 months of follow-up, 12 patients were free of disease, 2 remained ill, and 4 died of local recurrence or distant metastases.

Conclusions: Salvage surgery remains an effective treatment modality. CA sacrifice offers a viable treatment strategy. Major defects can be reconstructed with a trapezius flap.