When thinking about salvage surgery, physicians should be sure to consider the patient’s fitness for surgery, rule out distant metastases using positron emission tomography-computed tomography (PET-CT), provide realistic expectations to patients regarding the chances of a cure and their function after surgery, investigate the feasibility of the procedure, and take into account the possible need for reconstruction.
Role of Imaging
Surveillance is crucial for detecting the need for additional surgery early, and any change in symptoms should be considered recurrence until it’s proven not to be. Additionally, surveillance has to be individualized to account for specific patients’ circumstances, said Karen Pitman, MD, a head and neck surgeon with Banner Health in Arizona.
—Randal Weber, MD