Reconstruction in early squamous cell carcinoma of the oral cavity-Do free flaps improve oncological outcome?

IF 2.2 3区医学 Q2 Dentistry

Journal of Stomatology Oral and Maxillofacial Surgery Pub Date : 2024-10-16 DOI:10.1016/j.jormas.2024.102121

Julius Moratin, Sven Zittel, Oliver Ristow, Jürgen Hoffmann, Kolja Freier, Dominik Horn

{"title":"Reconstruction in early squamous cell carcinoma of the oral cavity-Do free flaps improve oncological outcome?","authors":"Julius Moratin, Sven Zittel, Oliver Ristow, Jürgen Hoffmann, Kolja Freier, Dominik Horn","doi":"10.1016/j.jormas.2024.102121","DOIUrl":null,"url":null,"abstract":"Background: Oral squamous cell carcinoma (OSCC) ranks on position 14 in global cancer analysis and makes up to 38 % of all head and neck squamous cell carcinomas. While surgery is accepted as first-line treatment of early tumors, the reconstructive approach is not standardized. Therefore, we evaluated the concept of ablative tumor removal and microvascular reconstruction in terms of oncological safety and surgical morbidity for early OSCCs.Methods: 262 patients received ablative tumor surgery with neck dissection together with microvascular reconstruction between 2010 and 2020. General clinical data was analyzed descriptively with regard to surgery time, duration of tracheotomy and hospitalization.Results: Estimated 5-year overall and progression-free survival was 85 % and 77 % respectively with no significant difference between stage I or II cancer patients. Tracheotomy was performed in 131 patients (50 %). 19 patients (7.3 %) were temporarily dependent to a gastric feeding tube. Flap loss occurred in 9 patients (3.4 %).Discussion: In a standardized setting, mean surgery time could be reduced constantly. We propose consistent tumor ablation, combined with elective neck dissection and microvascular reconstruction in early oral squamous cell carcinoma. The presented concept leads to excellent oncological and functional results with acceptable morbidity and short surgery times.","PeriodicalId":56038,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":" ","pages":"102121"},"PeriodicalIF":2.2000,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Stomatology Oral and Maxillofacial Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jormas.2024.102121","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Dentistry","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Oral squamous cell carcinoma (OSCC) ranks on position 14 in global cancer analysis and makes up to 38 % of all head and neck squamous cell carcinomas. While surgery is accepted as first-line treatment of early tumors, the reconstructive approach is not standardized. Therefore, we evaluated the concept of ablative tumor removal and microvascular reconstruction in terms of oncological safety and surgical morbidity for early OSCCs.

Methods: 262 patients received ablative tumor surgery with neck dissection together with microvascular reconstruction between 2010 and 2020. General clinical data was analyzed descriptively with regard to surgery time, duration of tracheotomy and hospitalization.

Results: Estimated 5-year overall and progression-free survival was 85 % and 77 % respectively with no significant difference between stage I or II cancer patients. Tracheotomy was performed in 131 patients (50 %). 19 patients (7.3 %) were temporarily dependent to a gastric feeding tube. Flap loss occurred in 9 patients (3.4 %).

Discussion: In a standardized setting, mean surgery time could be reduced constantly. We propose consistent tumor ablation, combined with elective neck dissection and microvascular reconstruction in early oral squamous cell carcinoma. The presented concept leads to excellent oncological and functional results with acceptable morbidity and short surgery times.

查看原文本刊更多论文

口腔早期鳞状细胞癌的重建--游离皮瓣能改善肿瘤治疗效果吗？

背景：口腔鳞状细胞癌（OSCC）在全球癌症分析中排名第 14 位，占所有头颈部鳞状细胞癌的 38%。虽然手术被认为是早期肿瘤的一线治疗方法，但重建方法尚未标准化。因此，我们从肿瘤安全性和手术发病率的角度评估了早期 OSCC 的消融性肿瘤切除和微血管重建概念。对手术时间、气管切开时间和住院时间等一般临床数据进行了描述性分析：结果：估计的 5 年总生存率和无进展生存率分别为 85% 和 77%，I 期或 II 期癌症患者之间无明显差异。131名患者（50%）进行了气管切开术。19名患者（7.3%）暂时依赖胃食管。9名患者（3.4%）出现皮瓣脱落：讨论：在标准化环境中，平均手术时间可以不断缩短。我们建议对早期口腔鳞状细胞癌采取一致的肿瘤消融术，并结合选择性颈部切除术和微血管重建术。该方案可获得良好的肿瘤学和功能效果，且发病率可接受，手术时间短。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Stomatology Oral and Maxillofacial Surgery Dentistry-Oral Surgery

CiteScore

2.20

自引率

9.10%

发文量

305

期刊介绍： J Stomatol Oral Maxillofac Surg publishes research papers and techniques - (guest) editorials, original articles, reviews, technical notes, case reports, images, letters to the editor, guidelines - dedicated to enhancing surgical expertise in all fields relevant to oral and maxillofacial surgery: from plastic and reconstructive surgery of the face, oral surgery and medicine, … to dentofacial and maxillofacial orthopedics. Original articles include clinical or laboratory investigations and clinical or equipment reports. Reviews include narrative reviews, systematic reviews and meta-analyses. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey Platforms.