Analysis of prognosis and disease progression after local recurrence of XXXX .

@entity1 @entity66 @entity5 @entity1066 @entity92 @entity320
BACKGROUND: Local recurrence of @entity320 is associated with a grave prognosis. However, the characteristics and the mode of disease progression for @entity1 with local recurrence have not been adequately addressed in the literature. METHODS: A retrospective analysis of @entity1 treated at a single institution revealed a subset of @entity1 (n = 648) with local recurrence of @entity320 as a first event. @entity1 characteristics, histologic determinants, and disease free interval were variables used to identify prognostic factors. RESULTS: In this group of @entity1 , male gender (P = 0. 0163), increasing age (P = 0.0001), head and neck primaries (P = 0. 0001), thicker @entity92 (P = 0.0022), deeper Clark levels (P = 0.0010), and @entity1066 of the @entity5 (P = 0.0348) suggested a shorter time until local recurrence. @entity92 (P = 0.0004), Clark level (P = 0.0043), and @entity1066 (P = 0.0001) still factored into the survival prognosis after recurrence. Truncal primaries (P = 0.0005) and @entity66 free intervals (P = 0.0098) were also associated with poorer outcomes after recurrence. Of the 648 @entity1 , 124 showed no progression, 196 developed another local recurrence, 178 developed in-transit/lymph node metastases, and 150 had systemic recurrences. Survival was only 33.6% for @entity1 with further metastases, compared with 77.4% for @entity1 with no progression of disease after a median follow-up of 38.9 months. CONCLUSIONS: There was a 48.5% mortality rate at 5 years of follow-up after local recurrence. Long term survival (> 10 years) was estimated to be 34.9%. The patterns of failure after local recurrence suggest that @entity1 may benefit from aggressive locoregional therapy.
