Full-Thickness Tumor Resection of Oral Cancer Involving the Facial Skin—Microsurgical Reconstruction of Extensive Defects after Radical Treatment of Advanced Squamous Cell Carcinoma

Abstract

Advanced tumors of the head and neck are challenging for the treatment specialist due to the need to synergize oncological and functional requirements. Free flap reconstruction has been established as the standard of care for defects following tumor resection. However, depending on the affected anatomic subsite, advanced tumors may impose specific difficulties regarding reconstruction, especially when full-thickness resection is required. This study aimed to evaluate reconstructive strategies and oncological outcomes in patients with full-thickness resection of the oral cavity. A total of 33 patients with extensive defects due to squamous cell carcinoma of the oral cavity were identified. Indications, reconstructive procedures, and clinical outcome were evaluated. Thirty-two patients (97%) presented locally advanced tumors (T3/T4). Complete tumor resection was achieved in 26 patients (78.8%). The anterolateral thigh flap was the most frequently used flap (47.1%), and the primary flap success rate was 84.8%. The cohort demonstrated a good local control rate and moderate overall and progression-free survival rates. Most patients regained full competence regarding oral alimentation and speech. Full-thickness tumor resections of the head and neck area may be necessary due to advanced tumors in critical anatomic areas. In many cases, radical surgical treatment leads to good oncological results. Free flap reconstruction has been shown to be a suitable option for extensive defects in aesthetically challenging regions.

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

“…Thus, if patients are submitted to inadequate treatments, this could lead to damage to oncological and functional outcomes in terms of quality of life. Among the most frequently described types of free flaps used to repair defects in the oral cavity, a recent study showed those: the ALT (82.7%), the radial forearm flap (9.1%), the scapula flap (9.1%), the fibula flap (6.1%) and the latissimus dorsi flap muscle (3%) 22 . Extensive tumour resections including full-thickness flaps are feasible, and reconstructive surgery becomes the best choice for restoring function and aesthetics and could be associated with higher rates of local control.…”

Análise Do Aumento Das Internações Por Sarampo E Diminuição Da Cobertura Vacinal No Período De 2010 a 2019 No Brasil

“…O retalho anterior de coxa é a alternativa mais versátil para reconstrução dos defeitos extensos, haja vista seu volume, bom comprimento do pedículo e baixa morbidade da área doadora. Além disso, a necessidade geral de retalhos maiores para defeitos de espessura total pode acarretar um risco maior de falha do retalho (21).…”

Interrelações Da Violência, Transtornos Mentais Comuns E Ideação Suicida

“…Embora a quimiorradiação primária seja uma opção relevante para alguns pacientes com doença localmente avançada, fatores como localização do tumor, realização prévia de terapia adjuvante em casos de tumores recorrentes, razões médicas ou inerentes aos pacientes e especialistas em tratamento, tornam a cirurgia radical a opção terapêutica principal para estes casos. A radioterapia (RT) adjuvante oferece boas taxas de controle local e regional, principalmente após abordagem cirúrgica primária, com vantagens que se baseiam na possibilidade de obtenção de resultados clínicos satisfatórios junto à ressecção completa do tumor, o que pode auxiliar na detecção e tratamento de possíveis metástases em linfonodos ocultos e na restauração de áreas onde a extensão tumoral seja acentuada, reduzindo o volume tumoral quando a RT for aplicada (21).…”