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.