This systematic review and meta-analysis investigated the impact of salvage surgery on 5-year overall survival (OS) and prognostic factors in recurrent oral cavity cancer (rOCC) patients. Relevant literature before May 2022 was reviewed, including retrospective cohort studies and observational studies comparing salvage surgery to other treatments. Risk-of-bias assessments were conducted using the Newcastle-Ottawa scale. Statistical and subgroup analyses assessed the impact of salvage surgery on 5-year OS and prognostic factors. 3036 documents were initially retrieved, with 14 retrospective cohort studies (2069 participants) included. Meta-analysis of 5-year OS in salvage surgery patients yielded a rate of 43.0%. Subgroup analysis showed higher OS in Asians (49.9% vs. 36.9%, p = 0.003) and late-relapse (63.8% vs. 30.0%, p = 0.004) groups. Prognostic factors revealed hazards associated with nodal recurrence, extranodal extension, and perineural invasion. Salvage surgery is a viable option for rOCC patients, showing favorable 5-year OS outcomes. Low publication bias enhances study reliability, but its single-arm design limits conclusions on salvage surgery superiority over other treatments.
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