Skip to main content
AAO-HNSF 2023 Annual Meeting & OTO Experience Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back
Rate ePoster

Head and Neck Surgery

(237) Hospitalization Ratio in Recurrent Head and Neck Cancer Salvage Surgery

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
Has Audio

    Presenting Author(s)

  • Preetha S. Velu, BA

    Medical Student
    Boston University Chobanian and Avedisian School of Medicine
    Boston, Massachusetts, United States

    • Co-Author(s)

  • RS

    Rishabh Sehra, BA

    University of Pittsburgh School of Medicine, USA

    • Senior Author(s)

  • Mark W. Kubik, MD

    Assistant Professory
    Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh School of Medicine
    McMurray, Pennsylvania, United States

Disclosure(s):
Preetha S. Velu, BA: No relevant relationships to disclose.
Mark W. Kubik, MD: No relevant relationships to disclose.


Introduction: Salvage surgery for head and neck mucosal squamous cell carcinoma (HNSCC) is often part of the standard of care for recurrent and residual disease. However, the effect of salvage surgery on clinical and quality of life outcomes is uncertain. We investigated prognostic factors, morbidity, and mortality of salvage surgery for recurrent or residual HNSCC.

Methods: We studied 68 patients from a prospective database who underwent salvage surgery with microvascular reconstruction for recurrent HNSCC between 9/1/2019 and 12/31/2021. Adult patients undergoing surgery at University of Pittsburgh Medical Center for recurrent or second primary disease after prior chemoradiation were included. Primary outcomes included time spent in the hospital and quality of life outcomes, which were assessed for prognostic indicators such as histology, stage, and grade. Hospitalization ratio, a measure that has not previously been studied in HNSCC, was defined as the ratio of length of hospital stay for any primary complaint related to salvage surgery to total days alive after surgery up to one year.

Results: For the 68 patients that met inclusion criteria, the mean disease free interval (DFI) for the total cohort was 35.88 ± 42.30 months, with no significant difference between subgroups. The mean length of stay of initial admission (LOS) for the total cohort was 11.26 ± 5.87 days with no significant difference in LOS between subgroups. The mean hospitalization ratio was 0.057 ± 0.083, meaning patients spent on average 5.7% of the first year after surgery in the hospital. The hospitalization ratio was not significantly different between subgroups. UW-QOL scores were available for 25 patients, and mean scores were significantly decreased between the pre-operative and post-operative periods for swallowing (p = 0.0057), chewing (p = 0.0079), and speech (p = 0.0001).

Conclusions: Salvage surgery for HNSCC may lead to increased hospital utilization and worse quality of life outcomes in certain patients. Future studies can use hospitalization ratio as a metric to study quality of life outcomes after oncologic surgery.