Submental island flap reconstruction in oral cavity cancer patients with pathological level I lymph node metastasis: Flap site recurrence and survival analysis

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Stomatology Oral and Maxillofacial Surgery Pub Date : 2025-03-03 DOI:10.1016/j.jormas.2025.102309

Donyarat Ruenmarkkaew, Orapan Sangiamporn, Hanpon Klibngern, Tapanut Ariyanon, Weerachai Watcharatsiriyuth, Pichit Sittitrai

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Abstract

Objectives

The study aimed to determine flap site recurrence rate in oral squamous cell carcinoma patients who had undergone reconstruction with submental island flap, to evaluate factors affecting flap site recurrence, particularly pathological level I lymph node status, and assess survival outcomes.

Methods

Fifty-six patients with squamous cell carcinoma of the oral cavity who underwent surgical resection and submental island flap reconstruction between October 2012 and February 2024 were enrolled onto the study. Tumor recurrence and survival outcomes were analyzed. A Kaplan-Meier estimate of locoregional recurrence-free survival (LRRFS), disease-specific survival (DSS), and overall survival (OS) was calculated. Factors affecting flap site recurrence and survival outcomes were assessed.

Results

Most patients (78.57 %) were in the advanced stage (stage III-IV), and 21.43 % had pathological level I lymph node metastasis. Flap site recurrence rate was observed in 5.36 % of cases, without any identifiable factors predicting the recurrence, including pathological level I lymph node metastasis. The 5-year LRRFS, DSS, and OS rates were 60.28 %, 84.55 %, and 67.38 %, respectively. Positive resection margin, perineural invasion, and extranodal extension adversely affected LRRFS.

Conclusions

Submental island flap reconstruction in selected oral squamous cell carcinoma patients is oncologically safe regarding low flap site recurrence rate, satisfactory survival outcomes, and pathological level I lymph node metastasis did not affect the flap site recurrence.

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口腔癌病理I级淋巴结转移患者颏下岛状皮瓣重建：皮瓣部位复发及生存分析。

目的：本研究旨在确定颏下岛状皮瓣重建口腔鳞癌患者皮瓣部位复发率，评价影响皮瓣部位复发率的因素，特别是病理I级淋巴结状态，并评估生存结果。方法：选取2012年10月至2024年2月间行口腔鳞状细胞癌手术切除及颏下岛状皮瓣重建的56例患者为研究对象。分析肿瘤复发和生存结果。计算局部无复发生存（LRRFS）、疾病特异性生存（DSS）和总生存（OS）的Kaplan-Meier估计。评估影响皮瓣复发和生存结果的因素。结果：晚期（iii ~ iv期）占78.57%，病理I级淋巴结转移占21.43%。皮瓣部位复发率为5.36%，未发现任何可预测复发的因素，包括病理I级淋巴结转移。5年LRRFS、DSS和OS分别为60.28%、84.55%和67.38%。阳性切缘、神经周围浸润和结外延伸对LRRFS有不利影响。结论：颏下岛状皮瓣重建术在部分口腔鳞癌患者中是肿瘤学上安全的，皮瓣复发率低，生存结果满意，病理I级淋巴结转移不影响皮瓣复发。

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