Outcomes of Reconstructing Large Oncosurgical Defects of the Lateral Face in Older Cutaneous Cancer Patients Using Cervicofacial and Cervicothoracic Flaps.

Abstract

Background: Older patients with cutaneous cancer often have comorbidities. Tumor resection and defect reconstruction in these patients are challenging.

Aims: To evaluate the safety and feasibility of cervicofacial (CFF) and cervicothoracic (CTF) flaps in the reconstruction of large oncosurgical defects in the lateral facial region of older patients.

Materials and methods: The study enrolled 36 patients with facial cutaneous cancers (age range, 65-94 years). They were divided into CFF and CTF groups in the facial region and in the neck. The clinical stages were I, II, and III in 6, 21, and 9 patients, respectively. The lateral face was divided into 3 aesthetic units: forehead, cheeks, and neck. Postoperative complications were scored using the Clavien-Dindo classification.

Results: The CFF was used to reconstruct oncosurgical defects in 8 foreheads and 16 cheeks; the CFF was used to reconstruct defects in 4 cheeks and 8 necks. The median sizes of skin defects in the CFF and CTF groups were 3.9×4.4 and 6.8×7.7 cm, respectively. There were no full flap failures. The Clavien-Dindo grades were I, II, and IIIa in 20, 9, and 2 patients, respectively, in the CFF and 0, 2, and 3 in the CTF group. Twenty-nine patients were alive without disease, 5 patients were alive with disease, and 2 patients had died of local recurrence or distant metastases.

Conclusions: The CFF and CTF are simple, reliable, and excellent methods for reconstructing large oncosurgical defects in the lateral face of older patients with cutaneous cancer.