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Free flap reconstruction in patients with advanced oral squamous cell carcinoma: Analysis of patient survival and cancer recurrence

Authors

  • Tung-Ying Hsieh M.D.,

    1. Division of Plastic and Reconstructive Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
    2. Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
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  • Kao-Ping Chang M.D., Ph.D.,

    Corresponding author
    1. Division of Plastic and Reconstructive Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
    2. Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
    3. Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
    • Division of Plastic and Reconstructive Surgery, Kaohsiung Medical University Hospital, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan
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  • Su-Shin Lee M.D.,

    1. Division of Plastic and Reconstructive Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
    2. Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
    3. Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
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  • Chih-Hau Chang M.D.,

    1. Division of Plastic and Reconstructive Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
    2. Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
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  • Ching-Hung Lai M.D.,

    1. Division of Plastic and Reconstructive Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
    2. Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
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  • Yi-Chia Wu M.D.,

    1. Division of Plastic and Reconstructive Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
    2. Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
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  • Shu-Hung Huang M.D.,

    1. Division of Plastic and Reconstructive Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
    2. Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
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  • Chung-Sheng Lai M.D., Ph.D.,

    1. Division of Plastic and Reconstructive Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
    2. Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
    3. Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
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  • Sin-Daw Lin M.D.

    1. Division of Plastic and Reconstructive Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
    2. Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China
    3. Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
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Abstract

Background:

The purpose of this study was to compare the initial conditions and treatment outcomes of patients with advanced stage IV oral squamous cell carcinoma (OSCC) treated with or without free flap reconstruction following ablative tumor resection.

Methods:

Two hundred forty-two pathological stage IV OSCC patients (without distant metastasis) treated by tumor ablation with free flap reconstruction (Group 1; n = 93) or without free flap reconstruction (Group 2; n = 149 treated with split-thickness skin grafts, primary closure of defects, secondary granulation of defects, and local or regional flaps) were recruited. We compared patient survival and cancer recurrence rates between these two groups.

Results:

Group 1 had significantly more advanced tumor stage than group 2. Despite the unfavorably expected prognosis in group 1, both positive margin rate (17.2% in Group 1 versus 23.5% in Group 2, P = 0.213) and cancer recurrence rate (36.6% in Group 1 versus 38.3% in Group 2; P = 0.792) were not significantly different between the two groups. The 5-year disease-specific survival were also the same (51.4% in Group 1 versus 52.6% in Group 2; P = 0.493).

Conclusions:

Although cancer stages were more advanced in patients requiring free flap reconstruction, patient survival, and cancer recurrence in the patients with free flap reconstruction were maintained as patients without free flap. © 2012 Wiley Periodicals, Inc. Microsurgery, 2012.

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