Reconstructive surgery and adjuvant radiotherapy for the multimodal approach in oral cancer: a single cancer centre experience

Author:

Bernaola-Paredes Wilber Edison1,Rodrigues Monica Lucia2,Carvalho Henrique Perez2,dos Santos Bitencourt Fernando2,Coutinho Marcelo Carvalho2,D’Almeida Costa Felipe3,Vallejo-Rosero Kleber Arturo4,Marquez-Zambrano Jose Agustin5,Pellizzon Antonio Cassio Assis1

Affiliation:

1. Radiation Oncology

2. Head and Neck Surgery & Otorhinolaryngology

3. Anatomic Pathology, A.C. Camargo Cancer Center, São Paulo, Brazil

4. Department of Oral and Maxillofacial Surgery, Central University of Ecuador, Quito, Ecuador

5. Department of Oral Pathology, School of Dentistry and Rehabiliation Sciences, San Sebastian University, Santiago, Chile.

Abstract

Introduction and importance: Ablative surgery for oral cancer, irrespective of the histological subtype, causes large tissue defects, functional and aesthetic damage. Microsurgical free flaps have been widely used in reconstruction after resection, with satisfactory success rates in conjunction with adjuvant radiotherapy (RT). This study aims to describe our clinical institutional experience based on the multimodal treatment performed in four cases diagnosed with oral squamous cell carcinoma with the use of different microvascular free flaps and RT. Case series presentation: Four patients underwent reconstructive microsurgery after surgical resection of oral cancer, using three types of free flap: radial forearm fasciocutaneous, osteomyocutaneous fibular, and anterolateral thigh musculocutaneous flaps; RT was performed in Case 2 and Case 3. In the period of 3 years after microsurgical reconstruction and RT, flaps remain clinically stable without failure signs in full patients submitted to multimodal treatment. Clinical discussion: After resection of oral carcinomas, extensive tissue defects can be successfully treated with reconstructive microsurgery using different types of microvascular free flaps. RT for locoregional control is a feasible option and did not seem to interfere with the survival of flaps. Conclusion: An enhance long-term follow-up to assess overall and disease-free survival rates and quality of life must be carried out; however, cohort studies would be necessary for better understanding of the role of each treatment in the multimodal scheme.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

General Medicine,Surgery

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