Salvage reconstruction of extensive recurrent oral cancer defects with the pectoralis major myocutaneous flap.
OBJECTIVE
This study aimed to evaluate the usefulness of the pectoralis major myocutaneous flap for reconstruction of oral and facial defects after excision of recurrent oral cancer and the results of salvage surgery.


METHODS
Twenty-four patients with recurrent squamous cell carcinoma of the oral cavity underwent salvage surgical treatment. Pectoralis major flaps were used for reconstruction of the extensive defects caused by excision of the tumors. The complications of the flap and the prognosis of the patients were analyzed with a follow-up from 5 to 65 months (mean = 18.5 months).


RESULTS
Fourteen flaps were used for mucosal lining of the mouth, and 10 flaps were used for reconstruction of the cutaneous defects. The overall success rate of the flap was 70.8%. Flap-related complications developed in 13 patients (54.2%). Major complications occurred in 7 patients (29.2%), and minor complications occurred in 6 (25.0%). Three patients (12.5%) had complications unrelated to the flap. The reconstruction of the base of the tongue, the floor of the mouth, and the oropharynx emerged as a significant risk factor for flap necrosis on binary logistic regression analysis (P < .05). The overall 1-, 3-, and 5-year overall survival rate was 72.8%, 30.9%, and 20.6%, respectively.


CONCLUSIONS
The pectoralis major myocutaneous flap is a reliable choice for reconstruction of extensive soft tissue defects caused by excision of recurrent oral cancer. The major complications correlate with the site of reconstruction. Many patients benefit from salvage surgery, and some of them can survive 2 to 4 years postoperatively.
Zou
Hao
H
Department of Oral and Maxillofacial Surgery, and Research Fellow, Key Laboratory of Oral Biomedical Engineering (Wuhan University), Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China.
Zhang
Wen-Feng
WF
Han
Qi-Bin
QB
Zhao
Yi-Fang
YF
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery*; D062109:Dermatologic Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000601:surgery; D009062:Mouth Neoplasms / Q000401:mortality / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery*; D010369:Pectoralis Muscles / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000209:etiology; D015996:Survival Rate; D016896:Treatment Outcome