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Priority of Fibular Reconstruction in Patients with Oral Cavity Cancer Undergoing Segmental Mandibulectomy

Author

Listed:
  • Chih-Hung Lin
  • Chung-Jan Kang
  • Chung-Kan Tsao
  • Christopher Glenn Wallace
  • Li-Yu Lee
  • Chien-Yu Lin
  • Hung-Ming Wang
  • Shu-Hang Ng
  • Tzu-Chen Yen
  • Chun-Ta Liao

Abstract

Background: The fibula osteoseptocutaneous free flap is generally used for segmental mandibular reconstructions following resection of oral cavity squamous cell carcinoma (OSCC). However, less complex reconstructions may be feasible for patients with predicted poor survival. Herein, we sought to identify the main risk factors (RFs) associated with poor prognosis in OSCC patients undergoing segmental mandibulectomy to help decide between fibular and non-fibular reconstructions. Methods: Between 1996 and 2011, we examined the 5-year control, distant metastases, and survival rates in 310 consecutive, previously untreated patients with primary OSCC who underwent segmental mandibulectomy. Results: Margin status was the only independent RF for 5-year local control. Level IV/V metastases, extracapsular spread, and tumor depth ≥15 mm were independent RFs for poor 5-year survival. In the entire study cohort, 23% of the patients had 2 or 3 adverse RFs; such a high-risk group was characterized by a poor prognosis and may be suitable for non-fibular reconstructions. Overall, 70% of the study patients were cT1-4N0, cT1N2, cT2N1, or had tumor depth

Suggested Citation

  • Chih-Hung Lin & Chung-Jan Kang & Chung-Kan Tsao & Christopher Glenn Wallace & Li-Yu Lee & Chien-Yu Lin & Hung-Ming Wang & Shu-Hang Ng & Tzu-Chen Yen & Chun-Ta Liao, 2014. "Priority of Fibular Reconstruction in Patients with Oral Cavity Cancer Undergoing Segmental Mandibulectomy," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-8, April.
    • Handle: RePEc:plo:pone00:0094315
    DOI: 10.1371/journal.pone.0094315
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