Multidisciplinary evidence-based consensus statements on salvage surgery for recurrent head and neck cancer (International Centre for Recurrent head and neck Cancer)
Williamson, Andrew Brady, Grainne Harris, Natalie Haris, Puteri Abdul Bisase, Brian Chiu, Kevin Douglas, Catriona Fleming, Jason Hamilton, David Haridass, Anoop
Williamson, Andrew
Brady, Grainne
Harris, Natalie
Haris, Puteri Abdul
Bisase, Brian
Chiu, Kevin
Douglas, Catriona
Fleming, Jason
Hamilton, David
Haridass, Anoop
Affiliation
The Royal Marsden NHS Foundation Trust; Institute for Cancer Research; Oxford University Hospitals NHS Foundation Trust; Queen Victoria Hospital NHS Foundation Trust; East and North Hertfordshire NHS Trust; NHS Greater Glasgow and Clyde, Glasgow; Liverpool University Hospitals NHS Foundation Trust; Newcastle Upon Tyne Hospitals NHS Foundation Trust; University of Liverpool; University Hospitals Bristol & Weston NHS Foundation Trust; University Hospitals Dorset NHS Foundation Trust; University of Southampton; London North West University Healthcare NHS Trust; University Hospitals Birmingham NHS Foundation Trust; Edinburgh University; NHS Lothian; University of Edinburgh; University of Oxford; University College London Hospitals NHS Foundation Trust; Guy's and St Thomas' NHS Foundation Trust
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Publication date
2025-06-14
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Abstract
Background: Recurrent head and neck squamous cell carcinomas (rHNSCC) are an understudied subgroup, lacking high quality evidence and thus gold standard management recommendations, resulting in significant variations in practice. The aim of this project was to deliver a national multi-disciplinary expert consensus on patients with rHNSCC managed by curative salvage surgery.
Methods: The AGREEII protocol guided the Delphi process. Best practice statements were developed after literature review on the perioperative management and surgical salvage of major rHNSCC subsites. Members of the International centre for Recurrent head and neck cancer (IREC) network, and other UK based professional stakeholder organisations were invited into an online Delphi study. Participants voted upon statements over three rounds, with items modified in response to vote thresholds and comments.
Results: Twenty-eight experts participated including 11 otolaryngologists, 7 oncologists, 9 oral and maxillofacial surgeons, and 1 speech and language therapist. Consensus was achieved on 73 statements, with 29 (39.7%) achieving unanimous (threshold: 100%) and 25 (34.2%) (threshold >90%) agreement.
Conclusions: Salvage surgery for rHNSCC are challenging cases that require intensive multidisciplinary input to achieve cure while balancing impact on function and quality-of-life. In this article, we provide a large series of statements based on UK-wide expert consensus, that will guide clinicians through the complex intra- and perioperative management of patients undergoing surgical salvage.
Citation
Williamson A, Brady G, Harris N, Haris PA, Bisase B, Chiu K, Douglas C, Fleming J, Hamilton D, Haridass A, Hughes C, Iqbal MS, Kerawala C, King E, Liu Z, McCaul J, Montgomery J, Nankivell P, Nixon I, Noble D, Nugent M, Paterson C, Pracy P, Riva F, Roe J, Schache A, Selbong U, Schilling C, Simo R, Winter S, O'Leary B, Paleri V. Multidisciplinary evidence-based consensus statements on salvage surgery for recurrent head and neck cancer (International Centre for Recurrent head and neck Cancer). J Natl Cancer Inst. 2025 Jun 14:djaf128. doi: 10.1093/jnci/djaf128. Epub ahead of print.
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Article