Jinbing Wang1, Yiran Tan1, Yi Shen1, Mingming Lv1, Jun Li2, Jian Sun3. 1. Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Center for Oral Disease, Shanghai 200011, PR China. 2. Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Center for Oral Disease, Shanghai 200011, PR China. Electronic address: 13636616199@163.com. 3. Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Center for Oral Disease, Shanghai 200011, PR China. Electronic address: jianjian60@yahoo.com.
Abstract
OBJECTIVES: To evaluate the oncological safety and reliability of the submental island flap (SIF) technique in patients with pathologically node-negative (pN0) and node-positive (pN+) T1-2 oral squamous cell carcinoma (OSCC) undergoing surgical tumor resection and concurrent SIF reconstruction. PATIENTS AND METHODS: Retrospectively, we reviewed patients with pN0 and pN+ T1-2 OSCC who underwent tumor resection and defect reconstruction with SIF from April 2008 to September 2016, focusing on flap viability, patterns and predictors of locoregional failure, salvage treatments, and oncologic prognosis. RESULTS: Of 160 patients with primary T1-2 OSCC, 33 were pN+ and 127 were pN0. All SIFs beside two were successful (98.75%). During follow-up, 18 patients experienced locoregional tumor relapse, of which 14 were pN0 and four were pN+. The 5-year recurrence-free survival was 88.73% vs. 86.93% for the pN0 and pN+ groups, respectively (p = .847). The pN + patients had poorer prognosis than pN0 patients (5-year overall survival, 66.35% vs. 91.10% respectively [p = .005]; disease-specific survival, 74.87% vs. 91.88% respectively [p = .016]). Multivariate analyses indicated there was no independent predictor for locoregional recurrence, but pN+ was predictive for poor prognosis (p = .03). CONCLUSION: SIF is a reliable flap for the reconstruction of OSCC-related small- and medium-sized soft tissue defect. With careful neck dissection and appropriate postoperative adjuvant treatment, the application of SIF did not increase the risk of locoregional tumor recurrence in patients with pN+ T1-2 OSCC compared with those with pN0 T1-2 OSCC.
OBJECTIVES: To evaluate the oncological safety and reliability of the submental island flap (SIF) technique in patients with pathologically node-negative (pN0) and node-positive (pN+) T1-2 oral squamous cell carcinoma (OSCC) undergoing surgical tumor resection and concurrent SIF reconstruction. PATIENTS AND METHODS: Retrospectively, we reviewed patients with pN0 and pN+ T1-2 OSCC who underwent tumor resection and defect reconstruction with SIF from April 2008 to September 2016, focusing on flap viability, patterns and predictors of locoregional failure, salvage treatments, and oncologic prognosis. RESULTS: Of 160 patients with primary T1-2 OSCC, 33 were pN+ and 127 were pN0. All SIFs beside two were successful (98.75%). During follow-up, 18 patients experienced locoregional tumor relapse, of which 14 were pN0 and four were pN+. The 5-year recurrence-free survival was 88.73% vs. 86.93% for the pN0 and pN+ groups, respectively (p = .847). The pN + patients had poorer prognosis than pN0 patients (5-year overall survival, 66.35% vs. 91.10% respectively [p = .005]; disease-specific survival, 74.87% vs. 91.88% respectively [p = .016]). Multivariate analyses indicated there was no independent predictor for locoregional recurrence, but pN+ was predictive for poor prognosis (p = .03). CONCLUSION: SIF is a reliable flap for the reconstruction of OSCC-related small- and medium-sized soft tissue defect. With careful neck dissection and appropriate postoperative adjuvant treatment, the application of SIF did not increase the risk of locoregional tumor recurrence in patients with pN+ T1-2 OSCC compared with those with pN0 T1-2 OSCC.