Does Microvascular free flap Reconstruction in oral Squamous cell Carcinoma Improve Patient Survival?

Marchetti, Claudio; Pizzigallo, Angelo; Cipriani, Riccardo; Campobassi, Angelo; Badiali, Giovanni

doi:10.1016/j.otohns.2008.08.019

Cited by 14 publications

(9 citation statements)

References 18 publications

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“…The results of this study indicated no statistical difference in the surgical margin when a free flap procedure was performed (coefficient, 0.789; 95% CI, À0.120 to 1.790; P = .099) These results are similar to other studies that have analyzed the surgical margin 14 and 5-year recurrence and survival rates 15,16 for free flap procedures.…”

Section: Non-statistically Meaningful Variablessupporting

confidence: 85%

High-Volume Surgeons Deliver Larger Surgical Margins in Oral Cavity Cancer

Ellis

David

Park

et al. 2016

Journal of Oral and Maxillofacial Surgery

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Purpose:Many factors are involved in oral cavity cancer surgery, and their association with the surgical margin; thus, patient outcomes are still not completely understood. This aim of this study was to determine which variable or variables had the greatest influence on increasing the size of the surgical margin. Methods:A retrospective cohort study was conducted at the Royal Brisbane and Women's Hospital of patients who underwent resective surgery for a primary oral cavity cancer between January 1, 2008 and December 31, 2012. The primary outcome variable was the surgical margin, defined as the closest distance between the surgical edge and invasive cancer. A heterogeneous set of predictor variables were identified as potentially impacting on the primary outcome variable: demographic, 5 surgical, and 7 histological variables. The data then underwent statistical analysis using univariable linear regression, and variables that were found to have a statistical association were retained in a non-interaction multivariable model. Results:250 patients were included in this study. The results demonstrated that highvolume surgeons delivered larger surgical margins than low-volume surgeons.The single most important variable associated with larger surgical margins M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPTwas who performed the resective operation. The following variables were also associated with smaller surgical margins: retromolar trigone location; non-SCC cancers; perineural invasion; and a lip-split mandibulectomy surigical approach. Conclusion:There was a strong association between high-volume surgeons and larger surgical margins; supporting the rationalization of oral cavity cancer management into high-volume centers and high-volume surgeons.

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Section: Non-statistically Meaningful Variablessupporting

confidence: 85%

High-Volume Surgeons Deliver Larger Surgical Margins in Oral Cavity Cancer

Ellis

David

Park

et al. 2016

Journal of Oral and Maxillofacial Surgery

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“…Various improvements in RT and chemotherapy regimens may have also had an impact on overall survival; however, the addition of postoperative chemotherapy is the only major shift in treatment in recent years. Modern surgical techniques allow reconstruction of more extensive defects, which could improve survival by allowing extirpative surgery in otherwise nonoperable patients or improving margin control in more extensive resections; however, the currently available literature is both limited and conflicting . We propose that the improvement in overall survival reflected in the national databases is at least partially because of the implementation of adjuvant CRT as a standard treatment option.…”

Section: Discussionmentioning

confidence: 99%

Improved overall survival and mortality in head and neck cancer with adjuvant concurrent chemoradiotherapy in national databases

Lin

Varvares

2015

Head Neck

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“…The authors consider free flap reconstruction recommended, especially when postoperative functional deficits are expected (Mücke et al, 2010). A small study also designed to evaluate the impact of microsurgical reconstruction on survival didn't show any significant improvement only a trend towards better prognosis (Marchetti et al, 2008). This study didn't directly compare the results of free flaps and pectoralis major pedicled flaps.…”

Section: Oncologic Resultsmentioning

confidence: 99%

Microsurgical Reconstruction of the Oral Cavity and Oropharynx After Cancer Ablation

Rodrigues¹,

Köhler²,

Kowalski³

2012

Oral Cancer

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Does Microvascular free flap Reconstruction in oral Squamous cell Carcinoma Improve Patient Survival?

Abstract: A comparison between our study group and those of 3 previous similar studies would not provide definitive statistical evidence, but it could certainly suggest a trend. The comparison seems to support that microvascular free tissue transfer does not change the survival of these patients.

Cited by 14 publications

References 18 publications

High-Volume Surgeons Deliver Larger Surgical Margins in Oral Cavity Cancer

High-Volume Surgeons Deliver Larger Surgical Margins in Oral Cavity Cancer

Improved overall survival and mortality in head and neck cancer with adjuvant concurrent chemoradiotherapy in national databases

Microsurgical Reconstruction of the Oral Cavity and Oropharynx After Cancer Ablation

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