Free flap reconstruction in patients with advanced oral squamous cell carcinoma: analysis of patient survival and cancer recurrence.
BACKGROUND
The purpose of this study was to compare the initial conditions and treatment outcomes of patients with advanced stage IV oral squamous cell carcinoma (OSCC) treated with or without free flap reconstruction following ablative tumor resection.


METHODS
Two hundred forty-two pathological stage IV OSCC patients (without distant metastasis) treated by tumor ablation with free flap reconstruction (Group 1; n = 93) or without free flap reconstruction (Group 2; n = 149 treated with split-thickness skin grafts, primary closure of defects, secondary granulation of defects, and local or regional flaps) were recruited. We compared patient survival and cancer recurrence rates between these two groups.


RESULTS
Group 1 had significantly more advanced tumor stage than group 2. Despite the unfavorably expected prognosis in group 1, both positive margin rate (17.2% in Group 1 versus 23.5% in Group 2, P = 0.213) and cancer recurrence rate (36.6% in Group 1 versus 38.3% in Group 2; P = 0.792) were not significantly different between the two groups. The 5-year disease-specific survival were also the same (51.4% in Group 1 versus 52.6% in Group 2; P = 0.493).


CONCLUSIONS
Although cancer stages were more advanced in patients requiring free flap reconstruction, patient survival, and cancer recurrence in the patients with free flap reconstruction were maintained as patients without free flap.
Division of Plastic and Reconstructive Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China.
Tung-Ying
TY
Hsieh
Kao-Ping
KP
Chang
Su-Shin
SS
Lee
Chih-Hau
CH
Chang
Ching-Hung
CH
Lai
Yi-Chia
YC
Wu
Shu-Hung
SH
Huang
Chung-Sheng
CS
Lai
Sin-Daw
SD
Lin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000637:transplantation*; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016038:Skin Transplantation; D013524:Surgical Flaps / Q000637:transplantation; D015996:Survival Rate; D016896:Treatment Outcome