Prediction of decannulation, oral intake recovery, overall survival and lung metastasis following oral malignant tumor resection and reconstruction

Abstract

Abstract. The present study investigated whether tongue base and mandibular bone defects were associated with the rate of decannulation and oral intake recovery, and survival time, including overall and lung metastasis-free survival time, in patients that underwent oral malignant tumor (OMT) resection with reconstruction. A total of 105 patients that underwent OMT resection with laryngeal preservation and reconstruction were recruited. The extent of defects was classified according to Urken's classification. The rates of decannulation and oral intake recovery were assessed with the Kaplan-Meier method. It was identified that 4-5 section segmental mandibulectomy (SM) and total glossectomy (TG) were significantly associated with a lower rate of decannulation and oral intake recovery by univariate and multivariate analysis using a Cox's proportional model. Patients in the high risk group (4-5 sections or TG) were significantly less likely to achieve decannulation and unaided oral intake. Patients in the high risk group exhibited a significantly shorter overall and lung metastasis-free survival time. Following multivariate analysis adjusted for the clinical stage (IV/I-III), past history of or postoperative radiotherapy (yes/no) and age (per year), the high risk group was associated with a significantly rate of decannulation and unaided oral intake. In conclusion, TG or wide SM is a prognostic parameter for functional and survival outcomes, including lung metastasis, in OMT.

Compartmental Surgery for Oral Tongue Cancer: Objective and Subjective Functional Evaluation

“…Overall, the most important variables influencing deglutition were adjuvant treatment, age, gender, oropharyngeal resection, and type of free flap employed, as previously reported in literature 19–23 . Performing functional evaluation at 6 and 12 months showed that it is reasonable to expect some improvements up to 1 year after surgery, as also confirmed by other studies 24–27 .…”

“…Overall, the most important variables influencing deglutition were adjuvant treatment, age, gender, oropharyngeal resection, and type of free flap employed, as previously reported in literature. [19][20][21][22][23] Performing functional evaluation at 6 and 12 months showed that it is reasonable to expect some improvements up to 1 year after surgery, as also confirmed by other studies. [24][25][26][27] It is interesting to note how at 1 year after treatment patients' subjective perception of swallowing is generally reported as good/satisfactory in more than 50% of cases using both the EORTC and UWQOL questionnaires.…”

“…Furthermore, most authors report significant deterioration of speech and swallowing only in patients requiring resections wider than an hemiglossectomy, thus involving the contralateral tongue compartment or the mandible. 17,21,23 In this view, when appropriately indicated, CTS for OTFOMSCC has the potential to offer superior oncologic results without significantly reducing functional outcomes compared to conventional partial glossectomy.…”

“…On this basis, a CTS approach represents the ideal setting due to the relatively standardized size, shape of defect, and amount of neural (lingual and hypoglossal nerves) and muscular (intrinsic and extrinsic muscles) structures routinely sacrificed according to the present surgical technique. Furthermore, most authors report significant deterioration of speech and swallowing only in patients requiring resections wider than an hemiglossectomy, thus involving the contralateral tongue compartment or the mandible 17,21,23 . In this view, when appropriately indicated, CTS for OTFOMSCC has the potential to offer superior oncologic results without significantly reducing functional outcomes compared to conventional partial glossectomy.…”

Role of Gd2O3‑doped carbon‑11‑choline‑lenvatinib nanoparticles contrast agent PET/CT in the diagnosis of patients with lung cancer

“…At present, lung tumor metastasis is the most difficult treatment barrier in cancer therapy (14)(15)(16). Therefore, obtaining an early diagnosis for human tumors is crucial for the effective treatment of human lung cancer (17).…”