BackgroundC-reactive protein (CRP) is an early marker for inflammation, and a relationship between serum CRP levels and survival in oral cancer has been demonstrated previously. In this study, we investigated the roles of CRP in different oral cancer subsites.MethodsThree hundred and forty-three oral squamous cell carcinoma patients between June 1999 and March 2015 were retrospectively reviewed. Serum CRP levels were measured preoperatively.ResultsThe elevation of CRP levels (≥5.0 mg/L) was significantly correlated with pathologic tumor status, pathologic nodal status, nodal extracapsular spread, tumor stage, skin invasion, tumor depth (≥10 mm), and bone invasion. The correlation between elevation of CRP and clinicopathologic factors was more evident in the buccal cancer compared to other tumor subsites. The disease-free survival and overall survival correlation was significant in buccal cancer (p = 0.003 and p < 0.001) but not in tongue cancer (p = 0.119 and p = 0.341) or other oral cancer subsites (p = 0.246 and p = 0.696).ConclusionsPreoperative serum CRP level was a prognosticator in oral squamous cell carcinoma, and its effect was more prominent in buccal cancer that occurs more frequently in areca-quid (AQ) endemic regions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12957-017-1116-5) contains supplementary material, which is available to authorized users.
Trismus release and free flap reconstruction after radiotherapy in oral and oropharyngeal cancer patients seems to be associated with modest long term results and a high incidence of trismus recurrence, particularly in cases of prior buccal resections or maxillectomy. Patients should be adequately informed and carefully selected before indicating the procedure.
Introduction
Trismus after oral cancer is frequent, with scarce evidence of surgical release treatment in these patients.
Objectives
The objective of this study is to determine the results of trismus release and free flap reconstruction after oral cancer treatment, establish immediate and long‐term results, and detect factors that influence outcome.
Materials and Methods
A retrospective study was performed. Preoperative, intraoperative, and follow‐up interincisal distances were measured. The intraoperative, long‐term gain, and postoperative loss were calculated. Analysis of the long‐term results with the preoperative and intraoperative variables was performed.
Results
Surgical release immediately increased the interincisal distance by 29.25 mm. Sixty‐six percent of this gain was lost due to trismus recurrence, giving a long‐term interincisal gain of 9.90 mm. Worse results were observed in patients with previous high‐stage tumors, maxillectomies, skin resections, and previous radiotherapy. The were no significant differences in the results depending on the type of release or reconstruction performed, with the exception of the reconstruction with the sural flap, which presented worse results. Patients with trismus of ≤10 mm could have more range for improvement after this surgery.
Conclusions
The results of this surgery are moderate in the long term due to high trismus recurrence in spite of aggressive treatment.
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