Giger R, et al. - Given that isolated regional lymph node recurrences in head and neck squamous cell carcinoma (HNSCC) are rare and there exists only limited data about its management, so researchers undertook this retrospective cohort analysis to report treatment modalities as well as outcomes and to explore prognostic factors. This study included patients exhibiting tumor persistence or recurrence following curatively intended treatment for HNSCC. Cases with synchronous secondary tumors at initial presentation, tumor persistence, local or locoregional recurrence, and systemic metastases were dismissed. Overall 76 cases were analyzed. Experts found that independent adverse prognostic factors for recurrence-free survival after isolated regional recurrences included initial stage IVA-B, extracapsular spread, higher involved/total lymph node ratio, and soft-tissue infiltration. Findings revealed a high incidence (25%) of occult additional metastasis of radiologically uninvolved levels during salvage neck dissections, thus, superselective or selective neck dissection would not have been satisfactory type of salvage surgery.