title: Impact of microvascular free flap reconstruction in oral cavity cancer: our experience in 130 cases.
abstract: The aim of this study was to investigate the oncological outcomes in patients affected by oral carcinoma treated with radical compartmental surgery followed by microvascular flap reconstruction. We conducted a retrospective analysis on a cohort of 130 patients. All patients underwent ablative tumour resection (compartmental surgery) followed by immediate reconstruction with free flaps and adjuvant chemoradiotherapy, when necessary according to our tumour board and international guidelines. Disease-specific survival (DSS) curves were obtained using the Kaplan-Meier method. Log-rank test and generalised Wilcoxon test were used to investigate the most important prognostic factors on 5-year DSS. A Cox proportional hazards model was constructed to provide hazard ratios or relative risks for individual variables. 88.5% of patients were affected by SCC. There were 46 (35.4%) women and 84 (64.6%) men in the sample with a mean age of 58.5 years. At the end of the follow-up period, 36 (27.7%) patients died, only 3 of which for other causes. The 5-year DSS rate was 67.8% (S.E. 4.9%). In univariate Kaplan-Meier analysis and in multivariate Cox regression model, seven variables were found to have a significant relationship with DSS: T (p = 0.026) and N (p = 0.0001) status, clinical stage (according to the UICC TNM Sixth Edition) (p = 0.007), margins of resection (p = 0.001), extracapsular spread (p = 0.005), recurrence of disease (p = 0.00002) and treatment modality (evaluated as surgery alone or surgery + RT/CHT) (p = 0.004). Our results confirmed findings already reported in the literature, and allowed us to conclude that compartmental surgery combined with free flap reconstruction can increase survival in oral cancer patients.
authors.affiliation: Department of Head and Neck Surgery - Otolaryngology, Catholic University of Sacred Heart, Rome, Italy;
authors.forename: G
authors.initials: G
authors.lastname: Almadori
authors.affiliation: Department of Head and Neck Surgery - Otolaryngology, Catholic University of Sacred Heart, Rome, Italy;
authors.forename: M
authors.initials: M
authors.lastname: Rigante
authors.affiliation: Department of Head and Neck Surgery - Otolaryngology, Catholic University of Sacred Heart, Rome, Italy;
authors.forename: F
authors.initials: F
authors.lastname: Bussu
authors.affiliation: Department of Head and Neck Surgery - Otolaryngology, Catholic University of Sacred Heart, Rome, Italy;
authors.forename: C
authors.initials: C
authors.lastname: Parrilla
authors.affiliation: Department of Head and Neck Surgery - Otolaryngology, Catholic University of Sacred Heart, Rome, Italy;
authors.forename: R
authors.initials: R
authors.lastname: Gallus
authors.affiliation: Department of Plastic and Reconstructive Surgery, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Barone Adesi
authors.affiliation: Department of Head and Neck Surgery - Otolaryngology, Catholic University of Sacred Heart, Rome, Italy;
authors.forename: J
authors.initials: J
authors.lastname: Galli
authors.affiliation: Department of Head and Neck Surgery - Otolaryngology, Catholic University of Sacred Heart, Rome, Italy;
authors.forename: G
authors.initials: G
authors.lastname: Paludetti
authors.affiliation: Department of Plastic and Reconstructive Surgery, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Salgarello
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Compartmental surgery; Microvascular free flaps; Oral cavity cancer; Survival