复发性头颈癌免疫治疗的进步需要更好地了解挽救性手术结果。本研究旨在确定挽救性头颈手术后的失败模式。对 1997 年至 2018 年因复发性粘膜鳞状细胞癌接受挽救性手术的 280 名患者进行了回顾性队列研究。使用非参数 Aalen-Johansen 估计量计算累积发生率。使用 Kaplan-Meier 方法估计复发时间 (TTR) 和总生存期 (OS)，并使用多变量 Cox 比例风险模型评估相关因素。第二次复发的 2 年和 5 年累积发生率为 48.3%（95 % CI 42.4-54.3) 和 54.9% (95% CI 48.9-60.8)。 5 年时，第二次局部区域复发的发生率是远处复发的两倍（41.5% [95% CI 35.6-47.4] vs. 21.7% [95% CI 16.8-26.6]）。中位 TTR 为 21.1 个月（95% CI 4.4-34.8），因部位而异（38.2 喉/下咽、13.9 口腔、8.3 鼻鼻和 7.8 口咽，P=.0001）。中位 OS 为 32.1 个月 (95% CI 24.1-47.6)，黑人患者（风险比 [HR] 2.15，95% CI 1.19-3.9）、当前吸烟者（HR 2.73，95% CI 1.53-4.88）患者的中位 OS 更差）、既往吸烟者（HR 2.00，95% CI 1.19-3.35）、≥ 60 岁（HR 1.41，95% CI 1.01-1.97）或接受多模式主要治疗（HR 1.98，95% CI 1.26-3.13）。挽救手术后的复发率和死亡率很低，但对于黑人、老年人、吸烟、接受过初始多模式治疗或患有鼻鼻癌或口咽癌的患者来说，复发率和死亡率更差。版权所有 © 2024。由 Elsevier Ltd 出版。

Advancements in immunotherapy for recurrent head and neck cancer have necessitated a better understanding of salvage surgical outcomes. This study aimed to determine patterns of failure following salvage head and neck surgery.A retrospective cohort study was conducted of 280 patients who underwent salvage surgery for recurrent mucosal squamous cell carcinoma from 1997 to 2018. Cumulative incidence was calculated using the nonparametric Aalen-Johansen estimator. Time to recurrence (TTR) and overall survival (OS) were estimated using the Kaplan-Meier method and multivariable Cox proportional hazard models were used to evaluate associated factors.The 2 and 5-year cumulative incidence rates of second recurrence were 48.3 % (95 % CI 42.4-54.3) and 54.9 % (95 % CI 48.9-60.8), respectively. At 5 years, second locoregional recurrence was twice as common as distant recurrence (41.5 % [95 % CI 35.6-47.4] vs. 21.7 % [95 % CI 16.8-26.6]). The median TTR was 21.1 months (95 % CI 4.4-34.8), which varied by site (38.2 larynx/hypopharynx, 13.9 oral cavity, 8.3 sinonasal, and 7.8 oropharynx, P=.0001). The median OS was 32.1 months (95 % CI 24.1-47.6) and was worse for patients who were Black (hazard ratio [HR] 2.15, 95 % CI 1.19-3.9), current smokers (HR 2.73, 95 % CI 1.53-4.88), former smokers (HR 2.00, 95 % CI 1.19-3.35), ≥ 60 years of age (HR 1.41, 95 % CI 1.01-1.97), or received multimodal primary therapy (HR 1.98, 95 % CI 1.26-3.13).Rates of recurrence and mortality after salvage surgery were poor but worse for patients who were Black, older, smoked, had initial multimodal therapy, or had sinonasal or oropharyngeal cancers.Copyright © 2024. Published by Elsevier Ltd.