title: Free flap reconstruction versus non-free flap reconstruction in treating elderly patients with advanced oral cancer.
abstract: OBJECTIVE
  Our goal was to evaluate whether elderly patients can benefit from free flaps.
  
  
  METHODS
  The clinical information from the included patients was reviewed, and these patients were asked to complete the University of Washington Quality of Life, version 4, questionnaire. Comparisons of the different scales between the 2 groups were performed.
  
  
  RESULTS
  The difference in the mouth-opening width before and after surgery did not differ significantly (P = .621) in the patients with and without free flap reconstruction. However, free flap placement tended to preserve the original mouth-opening width. No significant differences were found in recurrence-free survival or disease-specific survival between the 2 groups. The mean quality of life score of the 2 groups was 77.5 ± 10.4 and 72.1 ± 10.8. Significant differences were found in the chewing domain scores between the 2 groups (P = .039). Patients with free flap reconstruction tended to score better in the appearance and taste domains (P = .073 and P = .053, respectively); however, they required longer operative times, and longer postoperative hospital stays and incurred hospital costs.
  
  
  CONCLUSIONS
  Free flap reconstruction did not benefit elderly patients in mouth-opening width or survival analyses; the only quality of life domain that was significantly improved in patients undergoing free flap reconstruction was chewing. Free tissue transfer should be cautiously suggested for elderly patients with advanced oral cancer.
authors.affiliation: Resident, Department of Oromaxillofacial-Head and Neck Surgery, China Medical University School of Stomatology, Heping District, Shenyang, Liaoning, People's Republic of China.
authors.forename: Qi-Gen
authors.initials: QG
authors.lastname: Fang
authors.affiliation: Resident, Department of Pediatric Dentistry, China Medical University School of Stomatology, Heping District, Shenyang, Liaoning, People's Republic of China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Shi
authors.affiliation: Resident, Department of Endodontic Dentistry, Jilin University School of Stomatology, Dongchang District, Changchun, Jilin, People's Republic of China.
authors.forename: Mengjie
authors.initials: M
authors.lastname: Li
authors.affiliation: Resident, Department of Oromaxillofacial-Head and Neck Surgery, China Medical University School of Stomatology, Heping District, Shenyang, Liaoning, People's Republic of China.
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Professor, Department of Oromaxillofacial-Head and Neck Surgery, China Medical University School of Stomatology, Heping District, Shenyang, Liaoning, People's Republic of China.
authors.forename: Fa-Yu
authors.initials: FY
authors.lastname: Liu
authors.affiliation: Professor, Department Head, Department of Oromaxillofacial-Head and Neck Surgery, China Medical University School of Stomatology, Heping District, Shenyang, Liaoning, People's Republic of China. Electronic address: changfusun@hotmail.com.
authors.forename: Chang-Fu
authors.initials: CF
authors.lastname: Sun
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D009062:Mouth Neoplasms / Q000503:physiopathology / Q000601:surgery*; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps