Local Recurrence, the Value of Salvage Surgery and Overall Survival Following Treatment of Tumors of the Maxilla

Objective: To determine factors associated with local recurrence (LR), outcome of salvage surgery and overall survival (OS) following treatment of tumors of the maxilla.

Methods: Data was collected from patients treated for tumors of the maxilla between 2000 and 2015. Second primary and sino nasal tumours were excluded. Kaplan-Meier survival analysis was used to determine two-year local control rate and OS following the initial treatment and following salvage treatment. Cox proportional hazard regression was used to determine which factors were associated with LR.

Results: 128 patients were included in this study. 18% of the patients developed LR. 17% of these recurrences were successfully salvaged. LR was associated with type of tumour (MSCC)(p=.044). LR of MSCC was associated with vascular invasion (HR 4.985, p=.002) and bone invasion (HR 3.506, p=.045). Salvage surgery for recurrent MSCC confined to the area of the original tumour significantly prolonged OS compared to salvage surgery requiring resection of adjacent facial structures (p=.005). OS following salvage surgery requiring resection of adjacent facial structures was similar to OS following palliative treatment.

Conclusion: 18% of the patients developed LR. LR was associated with type of tumour (MSCC). LR of MSCC was associated with vascular invasion and bone invasion. Salvage surgery can be considered for small recurrences but has dubious value for larger recurrences infiltrating adjacent facial structures.