[Radical excision followed by reconstruction of recurrent cancers of the head and neck].

Various modalities of treatment for recurrent cancers of the head and neck were studied and discussed, focusing especially on radical excision followed by reconstruction. Thirty-two patients with recurrent cancer of the head and neck were given this treatment over a 12-year period. Pectoralis major myocutaneous flap was most commonly used for reconstruction, while free latissimus dorsi myocutaneous flap with microneurovascular anastomosis was used for total cheek defect after surgery for cancer of the maxillary sinus. Five-year survival was 62% in cases of radical excision followed by reconstruction. Simple resection of recurrent lesions was conducted in 36 cases and the 5-year survival was also 62%. Radical neck dissection was performed in 22 cases in which cervical node metastases developed after control of the primary tumor, and the 5-year survival was 52%. On the other hand, the 5-year survival was not obtained in cases treated with radiotherapy alone in this series, while the 5-year survival was only 1% in cases treated with chemotherapy alone. It was concluded that surgery was the most reliable treatment for recurrent cancers of the head and neck, and that radical excision followed by reconstruction played an important role as salvage surgery.