Tolerance of surgery after radical radiotherapy of carcinoma of the oropharynx

The complications of salvage surgery after radical irradiation were studied in a group of 52 patients with oropharyngeal carcinomas. These patients were selected for surgery from a group of patients who had failed protocol therapy and who were registered in the Split-Course Study of the Radiation Therapy Oncology Group. The operative mortality was 1.9% (1/52). The most frequent serious complication was pharyngocutaneous fistua in 12% (6/52) of patients who underwent operations. The overall incidence of serious complications was 21% (11/52). The actuarial estimated five-year survival for the group who had undergone operation was 27%. We conclude that salvage surgery for residual or recurrent disease in oropharyngeal cancer after radical radiotherapy is feasible with a low surgical mortality and acceptable complication rates.