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01-01-2010 | Reconstructive Oncology

Immediate Microsurgical Reconstruction After Tumor Ablation Predicts Survival Among Patients with Head and Neck Carcinoma

Authors: Thomas Mücke, MD, Klaus-Dietrich Wolff, MD, DDS, PhD, Stefan Wagenpfeil, MSc, PhD, David A. Mitchell, MD, FDS, FRCS, Frank Hölzle, MD, DDS, PhD

Published in: Annals of Surgical Oncology | Issue 1/2010

Abstract

Background

The purpose of this study was to examine whether or not immediate microvascular free flap reconstruction influences survival among treated patients suffering from oral squamous cell carcinoma (OSCC), controlling for demographic, clinical, and tumor characteristics.

Methods

773 patients with OSCC were treated with curative intent. Two hundred and seventy-four patients were immediately reconstructed using free microsurgical flaps. All measures were collected by chart abstraction. Kaplan–Meier plots and univariate log-rank test and multivariate Cox proportional hazards regression models were used to determine the association between possible predictor variables and survival time. In addition, a randomized matched-pair analysis was conducted to compensate different patient cohorts.

Results

After controlling for age, tumor stage, nodal stage, and tumor grade, which were independent and dependent predictors of survival, microsurgical free flap reconstruction was associated with survival [hazard ratio (HR) = 0.66, P < 0.001, 95% confidence interval (CI), 0.52 to 0.83]. In the randomized matched-pair analysis this effect became more evident (HR = 0.58, P < 0.001, 95% CI, 0.44 to 0.75). Controlling for extent of tumor, only T3 and T4 tumors were significantly associated with survival (P < 0.001, HR = 0.46, 95% CI, 0.31 to 0.69) when the area of defect was reconstructed, whereas in T1 and T2 tumors no significance was noted (P = 0.08, HR = 0.74, 95% CI, 0.53 to 1.04).

Conclusions

Reconstruction of defects, especially in patients presenting with higher tumor stages, is not associated with shorter overall survival rates, as revealed in this study, and should be considered when functional deficits due to tumor ablation can be expected postoperatively.

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Title: Immediate Microsurgical Reconstruction After Tumor Ablation Predicts Survival Among Patients with Head and Neck Carcinoma
Authors: Thomas Mücke, MD
Klaus-Dietrich Wolff, MD, DDS, PhD
Stefan Wagenpfeil, MSc, PhD
David A. Mitchell, MD, FDS, FRCS
Frank Hölzle, MD, DDS, PhD
Publication date: 01-01-2010
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 1/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-009-0758-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Immediate Microsurgical Reconstruction After Tumor Ablation Predicts Survival Among Patients with Head and Neck Carcinoma

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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