title: Survival after free flap reconstruction in patients with advanced oral squamous cell carcinoma.
abstract: OBJECTIVE
  The purpose of the present study was to assess the effect of free-flap reconstruction on the survival of patients treated for oral squamous cell carcinoma.
  
  
  METHODS
  The present study was based on a retrospective cohort of 98 patients. Of the 98 patients, 49 underwent surgical reconstruction with microvascular tissue transfer (test group) and in 49 (control group), only local or regional flaps were used.
  
  
  RESULTS
  For the free-flap group, the average follow-up period was 34.6 months. For the control group, the average follow-up was 39.8 months. At the end of the follow-up period, 23 (47%) and 33 (67.3%) patients had died of oral squamous cell carcinoma in the microvascular reconstructive and control group, respectively. The difference in the final status between the 2 groups was statistically significant (P = .03). In the free-flap group, the mean and median survival time was 65 and 60 months. In the locoregional flap group, the mean and median survival time was 54 and 24 months, respectively. No difference was seen in the survival time between the free-flap and local flap groups (P = .2). Univariate Kaplan-Meier analysis revealed that positive surgical margins were significantly associated with shortened survival in the free-flap group and that recurrence was significant in both reconstructive groups. On multivariate Cox regression analysis, the status of the resection margin (P = .07) and tumor recurrence (P < .0005) showed a significant relationship with survival.
  
  
  CONCLUSIONS
  Patients with free-flap reconstruction of surgically created defects after oral cancer resection showed a trend toward better 5-year survival.
authors.affiliation: Servicio de Cirugía Maxilofacial, Hospital Universitario Central de Asturias, Instituto Universitario de Oncología del Principado de Asturias, and Facultad de Medicina, Julián Clavería, Oviedo, Asturias, Spain. jvicente@uniovi.es
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: de Vicente
authors.forename: Tania
authors.initials: T
authors.lastname: Rodríguez-Santamarta
authors.forename: Pablo
authors.initials: P
authors.lastname: Rosado
authors.forename: Ignacio
authors.initials: I
authors.lastname: Peña
authors.forename: Lucas
authors.initials: L
authors.lastname: de Villalaín
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D016022:Case-Control Studies; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000098:blood supply; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D015996:Survival Rate; D016896:Treatment Outcome