Journal Title
Title of Journal: Eur J Plast Surg
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Abbravation: European Journal of Plastic Surgery
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Publisher
Springer-Verlag
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Authors: Mônica Lúcia Rodrigues Hugo Fontan Köhler José Magrin Alexsander Bressan José Carlos Marques de Faria Luiz Paulo Kowalski
Publish Date: 2010/06/22
Volume: 34, Issue: 2, Pages: 75-80
Abstract
The objective of this study is to evaluate the impact of microsurgical reconstruction on local recurrence rates and diseasespecific survival in patients with oral squamous cell carcinoma This study is a retrospective review of patients treated at a tertiary cancer center Six hundred and five patients were included in this study with 529 males 8744 and 76 females 1256 These were composed of 467 7719 pedicledflaps reconstructions and 138 2281 freeflap procedures There was no difference between the groups regarding T stage N stage or type of oncological surgery Use of postoperative radiotherapy was more common in the freeflap group with a significantly shorter time interval than the pedicledflap group Freeflap patients had a lower proportion of compromised/close surgical margins p 00001 Univariate analysis disclosed as significant for local recurrence gender T stage microsurgical reconstruction lymphatic embolization neural infiltration and surgical margins In a multivariate model T stage p 0001 neural infiltration p 0001 and microsurgical reconstruction p 0001 remained significant Significant factors for survival in univariate analysis were gender T stage N stage synchronous neck dissection microsurgical reconstruction lymphatic embolization neural infiltration and surgical margins In a multivariate analysis T stage p 0001 N stage p 0001 synchronous neck dissection p = 0025 microsurgical reconstruction p 0001 lymphatic embolization p = 0023 and neural infiltration p 0001 remained significant Regression trees show a significant impact of free flaps in T3/T4 primary tumors Use of microsurgical flaps provides a significant improvement in local recurrence and survival in patients with T3–T4a primary tumors It also reduces the interval between surgery and radiotherapy
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