[Outcome after resection of extensive oropharyngeal carcinomas and defect coverage by microvascular anastomosis of a radialis flap].
BACKGROUND
Extensive tumors of the oropharynx require an open approach and plastic reconstruction for good oncologic and functional results.


METHODS
From January 1988 through December 1996 at the Department of Otolaryngology, Head and Neck Surgery, of the University of Würzburg, 62 patients with extensive tumors of the oropharynx underwent surgical treatment (T2 = 6, T3 = 24, T4 = 32). In 40 patients, the resection was performed via a median mandibulotomy approach, in 22 patients using a lateral pharyngotomy. All patients underwent postoperative radiotherapy up to 70 Gy.


RESULTS
Using the Kaplan-Meier method, the five-year survival was 80% for T2, 52% for T3, and 22% for T4. Four patients (7%) presented with a second primary carcinoma, and one also had a third carcinoma. Seven patients who died of T3- and T4-tumors had distant metastases, among them 5 patients who were free of local disease. A regular oral diet was possible on average 14 days postoperatively. All patients underwent tracheostomy. Ninety percent of them were decanulated one year postoperatively.


CONCLUSIONS
Resection of extensive carcinomas of the oropharynx and microvascular reconstruction produces good oncological and functional results. The best access to extensive tumors is provided by a mandibulotomy. The advantage of this excellent approach outweighs an increasing morbidity in occasional cases.
Universitäts-Hals-Nasen-Ohrenklinik Würzburg. K.Schwager@mail.uni-wuerzburg.de
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Schwager
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Hoppe
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Hagen
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Brunner
D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018714:Radiotherapy, Adjuvant; D013524:Surgical Flaps; D015996:Survival Rate
Ergebnisse nach Resektion ausgedehnter Oropharynxkarzinome und Defektdeckung durch den mikrovaskulär anastomosierten Radialislappen.