The role of the T‐N tract in advanced stage tongue cancer

Tagliabue, Marta; Gandini, Sara; Maffini, Fausto; Navach, Valeria; Bruschini, Roberto; Giugliano, Gioacchino; Lombardi, Francesca; Chiocca, Susanna; Rebecchi, Elisabetta; Sica, Eleonora; Tommasino, Massimo; Calabrese, Luca; Ansarin, Mohssen

doi:10.1002/hed.25761

Cited by 41 publications

(49 citation statements)

References 48 publications

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“…The metastasis of the lymph nodes of the floor of the mouth is difficult to observe and diagnose [4]. As a result, it has been proposed that the radical dissection of tongue cancer should contain both the primary lesions and possible pathways of metastasis, including the partial suprahyoid muscle groups and the lymphatic, neurovascular, and glandular tissues [5,7,8]. In this study, we resected the primary lesions and partial suprahyoid muscle groups in all cases.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the thoroughness of the resection in the case of tongue cancer is of particularly importance. It has been recently suggested that the upper lingual muscle groups, such as the genioglossus muscle, geniohyoid muscle, mylohyoid muscle, and/or anterior belly of digastric muscle should also be resected in the radical resection to reduce the possibility of recurrence [5,7,8]. However, defects in the mouth floor and submandibular region post-operation result in the creation of a large unused space, leading to complications such as submandibular wound infection and oral fistula, thereby prolonging the recovery period of the patients and seriously affecting their prognosis [7,9].…”

Section: Introductionmentioning

confidence: 99%

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Application of chimerical ALT perforator flap with vastus lateralis muscle mass for the reconstruction of oral and submandibular defects after radical resection of tongue carcinoma: a retrospective cohort study

Yang

Wu²,

Kumar

et al. 2020

BMC Oral Health

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Background: Patients with tongue carcinoma who undergo combined tongue and neck radical resection often have simultaneous oral and submandibular defects. Due to its high flexibility, the anterolateral thigh (ALT) perforator flap is gradually being adopted by surgeons for oral reconstruction. However, the tissue volume of perforator flaps is insufficient for the reconstruction of both the oral and submandibular regions. In this retrospective cohort study, we compared the postoperative outcomes and complications between patients reconstructed with using the classical ALT perforator flap and patients reconstructed using the chimeric ALT perforator flap with vastus lateralis muscle mass. Methods: From August 2017 to August 2019, 25 patients underwent reconstructive therapy using a classical ALT perforator flap (classical group), while 26 patients were reconstructed with the chimeric ALT perforator flap (chimeric group) after radical resection of tongue cancer in Xiangya Hospital, Central South University. The flap survival rate, incidence of submandibular infection, lateral appearance, lower extremity function, and quality of life were compared between the two groups. Results: There were no differences in flap survival rate and postoperative lower extremity function between the two groups. The incidence of submandibular infection was 15.4 and 40% in the chimeric and classical group, respectively. The duration of recovery was 12.20 ± 2.69 and 15.67 ± 4.09 days in the chimeric and classical group, respectively. The submandibular region fullness was satisfactory in the chimeric group. The postoperative quality of life in the chimeric group was better than that in the classical group (P < 0.05). Conclusions: The chimerical ALT perforator flap with muscle mass reconstructs both the oral and submandibular defects accurately. It maintains the profile and fullness of the submandibular region and may reduce the incidence of submandibular infection.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Application of chimerical ALT perforator flap with vastus lateralis muscle mass for the reconstruction of oral and submandibular defects after radical resection of tongue carcinoma: a retrospective cohort study

Yang

Wu²,

Kumar

et al. 2020

BMC Oral Health

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“…Also, the tumor cells can move longitudinally along the path with the least resistance [19]. As a result, some scholars have proposed that the radical dissection of tongue cancer should contain primary lesions and all possible pathways of metastasis, including suboral and partial suprahyoid muscle groups, lymphatic, neurovascular and glandular tissues [5,7,8]. However, this operation method could leave extensive dead cavity in the floor of the mouth and submandibular region, which may lead to submental and submandibular infection and fistula.…”

Section: Discussionmentioning

confidence: 99%

“…However, this operation method could leave extensive dead cavity in the floor of the mouth and submandibular region, which may lead to submental and submandibular infection and fistula. The wound healing process was subsequently affected and the postoperative submandibular shape was depressed obviously [7,9]. Bar graph illustrated the differences of LEFS between the experimental and the control groups…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the thoroughness of the resection is of particularly important. Recently, it has been suggested that the upper lingual muscle groups such as genioglossus muscle, hyoid muscle, geniohyoid muscle, mandibular hyoid muscle and / or anterior abdomen of digastric muscle should also be resect in the radical resection to reduce the possibility of recurrence [5,7,8]. However, the defect of mouth floor and submandibular region after operation leads to a large dead cavity, which causes the complications such as submandibular wound infection and oral fistula, prolongs the recovery period of the patients, and seriously affects the prognosis [7 9].…”

Section: Introductionmentioning

confidence: 99%

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Application of chimerical ALT perforator flap with vastus lateralis muscle mass in the reconstruction of oral and submandibular defects after radical resection of tongue carcinoma: a retrospective clinical study

Yang

Ajit

et al. 2019

Preprint

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Background: Patients with tongue carcinoma who undergo combined tongue and neck radical resection often have the oral and submandibular defects simultaneously. Because of the high flexibility, the anterolateral thigh (ALT) perforator flap is gradually being adopted by the surgeons for the oral reconstruction. However, the tissue volume of a perforator flap is insufficient for the reconstruction of both oral and submandibular regions. In this retrospective study, we compared the postoperative effects and complications between two groups of patients. One group was reconstructed with the classical ALT perforator flap and the other was reconstructed with the chimeric ALT perforator flap with a mass of vastus lateralis muscle. Methods: From Aug 2017 to Aug 2019, 25 patients were reconstructed with classical ALT perforator flap (classical group), while 26 patients were reconstructed with the chimeric ALT perforator flap (chimeric group) after radical resection of tongue cancer in Xiangya Hospital, Central South University. The flap survival rate, incidence of submandibular infection, lateral appearance, lower extremity function, and quality of life were compared between two groups. Results: There were no differences in flap survival rate and postoperative lower extremity function between the two groups. The incidence of submandibular infection was 15.4％ and 40％ in the chimeric and classical group, respectively. The duration of recovery was 12.20±2.69 and 15.67±4.09 days in the chimeric and classical group, respectively. The submandibular region was fullness and satisfactory in chimeric group. The postoperative life quality in the chimeric group was better than that in the classical group ( P ＜0.05). Conclusions: The chimerical ALT perforator flap with muscle mass can reconstruct the oral and submandibular defects accurately. It maintains the profile and fullness of the submandibular region and reduces the incidence of submandibular infection.

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Prognostic Value of Anteroposterior Extension in Oral Tongue and Floor Squamous Cell Carcinoma

Contro,

Sordi,

Taboni

et al. 2024

JAMA Otolaryngol Head Neck Surg

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ImportanceThe tongue and oral floor represent the most involved subsite by oral cancer, and there are no reported systems to classify anteroposterior tumor extension with prognostic effect. In other cancers, the anterior vs posterior tumor extension is a relevant prognostic factor.ObjectiveTo establish whether anterior vs posterior tumor extension may represent a prognostic factor in oral tongue and floor squamous cell carcinoma (OTFSCC).Design, Setting, and ParticipantsThis was a retrospective cohort study of patients who underwent surgery for OTFSCC from January 1, 2010, to December 31, 2021, at 2 tertiary-level academic institutions in Italy (University of Padua and University of Brescia). Patients eligible for the study had histologically proven primary OTFSCC; underwent surgery-based, curative treatment; and had available preoperative contrast-enhanced imaging.ExposuresFour anatomical lines were designed to assess tumor extension: (1) chin-palate line (CPL), (2) chin-basion line, (3) Stensen duct line, and (4) lingual septum line. Preoperative imaging was re-evaluated, and tumor extension was classified as either anterior or posterior according to the lines.Main Outcomes and MeasuresOverall survival and time to recurrence (TTR) were evaluated according to tumor extension. These outcomes were reported as 5-year survival rates with 95% CIs.ResultsOf the 133 patients included, 79 (59.4%) were male, and the mean (SD) age was 62.7 (15.4) years. The 5-year TTR difference was higher for posterior vs anterior OTFSCC classified according to CPL (21.0%; 95% CI, 8.3%-33.7%), Stensen duct line (15.5%; 95% CI, 1.0%-30.0%), and lingual septum line (17.2%; 95% CI, 2.2%-32.3%). Overall survival analysis showed similar results. At the multivariable analysis on TTR, N status (adjusted hazard ratio [HR], 3.0; 95% CI, 1.2-7.1) and anteroposterior classification according to CPL (adjusted HR, 7.1; 95% CI, 0.9-54.6) were the variables associated with the highest adjusted HRs.Conclusions and RelevanceIn this cohort study, OTFSCC with a posterior extension to the CPL was associated with a higher risk of recurrence and death. This analysis suggests that the poor prognosis conveyed by the posterior tumor extension is independent of other relevant prognosticators except for the burden of nodal disease. This estimate is not precise and does not allow for definitive clinically important conclusions; therefore, further prospective studies are necessary to confirm these data.

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The role of the T‐N tract in advanced stage tongue cancer

Cited by 41 publications

References 48 publications

Application of chimerical ALT perforator flap with vastus lateralis muscle mass for the reconstruction of oral and submandibular defects after radical resection of tongue carcinoma: a retrospective cohort study

Application of chimerical ALT perforator flap with vastus lateralis muscle mass for the reconstruction of oral and submandibular defects after radical resection of tongue carcinoma: a retrospective cohort study

Application of chimerical ALT perforator flap with vastus lateralis muscle mass in the reconstruction of oral and submandibular defects after radical resection of tongue carcinoma: a retrospective clinical study

Prognostic Value of Anteroposterior Extension in Oral Tongue and Floor Squamous Cell Carcinoma

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