Reconstruction of Soft Tissue Defects Using Microsurgical Flaps

Cuéllar, Ignacio Navarro; Otero, Teresa González; Cruz, José Alfonso Ruiz; Vila, Carlos Navarro

doi:10.1007/978-3-319-20487-1_4

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…The treatment options for patients with early stages of oral cavity squamous cell carcinoma (I, II) are focused on the management of the primary tumour and the N0 neck. For the primary neoplasm, the two treatment options are surgery (extensive tumour resection and immediate reconstruction) [4,[21][22][23][24] and radiotherapy [25,26]. The management of the N0 neck is more controversial.…”

Section: Discussionmentioning

confidence: 99%

Depth of Invasion: Influence of the Latest TNM Classification on the Prognosis of Clinical Early Stages of Oral Tongue Squamous Cell Carcinoma and Its Association with Other Histological Risk Factors

Navarro Cuéllar,

Espías Alonso,

Alijo Serrano

et al. 2023

Cancers

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Background: The American Joint Committee on Cancer (AJCC), in its 8th edition, introduces modifications to the previous TNM classification, incorporating tumour depth of invasion (DOI). The aim of this research is to analyse the prognosis (in terms of disease-free survival and overall survival) of clinical early stage (I and II) squamous cell carcinomas of the oral tongue according to the DOI levels established by the AJCC in its latest TNM classification to assess changes to the T category and global staging system and to evaluate the association between DOI and other histological risk factors. Methods: A retrospective longitudinal observational study of a series of cases was designed. All patients were treated with upfront surgery at our institution between 2010 and 2019. The variables of interest were defined and classified into four groups: demographic, clinical, histological and evolutive control. Univariate and multivariate analyses were carried out and survival functions were calculated using the Kaplan–Meier method. Statistical significance was established for p values below 0.05. Results: Sixty-one patients were included. The average follow-up time was 47.42 months. Fifteen patients presented a loco-regional relapse (24.59%) and five developed distant disease (8.19%). Twelve patients died (19.67%). Statistically significant differences were observed, with respect to disease-free survival (p = 0.043), but not with respect to overall survival (p = 0.139). A total of 49.1% of the sample upstaged their T category and 29.5% underwent modifications of their global stage. The analysis of the relationship between DOI with other histological variables showed a significant association with the presence of pathological cervical nodes (p = 0.012), perineural invasion (p = 0.004) and tumour differentiation grade (p = 0.034). Multivariate analysis showed association between depth of invasion and perineural invasion. Conclusions: Depth of invasion is a histological risk factor in early clinical stages of oral tongue squamous cell carcinoma. Depth of invasion impacts negatively on patient prognosis, is capable per se of modifying the T category and the global tumour staging, and is associated with the presence of cervical metastatic disease, perineural invasion and tumoural differentiation grade.

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Section: Discussionmentioning

confidence: 99%

Depth of Invasion: Influence of the Latest TNM Classification on the Prognosis of Clinical Early Stages of Oral Tongue Squamous Cell Carcinoma and Its Association with Other Histological Risk Factors

Navarro Cuéllar,

Espías Alonso,

Alijo Serrano

et al. 2023

Cancers

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“…When secondary intention healing is not possible, microvascular free tissue transfers can often provide a functionally aesthetic replacement. This being said, lacunas are still present, namely: (1) an altered tissue texture, (2) scarring, weakened muscular ability and loss of sensation at the transplant and donor sites, (3) a patient's inadmissibility for surgery based on his clinical history, (4) tissue necrosis, and (5) infections (Navarro Cuellar et al., ). For these reasons, we believe it is important to investigate how tissue regeneration can be achieved in animal models to help solve oral‐facial tissue reconstruction limitations in humans.…”

Section: Introductionmentioning

confidence: 99%

Oral‐Facial Tissue Reconstruction in the Regenerative Axolotl

2016

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Absence of large amounts of orofacial tissues caused by cancerous resections, congenital defects or trauma result in sequelae such as dysphagia and noticeable scars. Oral-neck tissue regeneration was studied in the axolotl (regenerative amphibian) following a 2.5mm punch biopsy that simultaneously removed skin, connective tissue, muscle, and cartilage in the tongue and intermandibular region. The untreated wound was studied macroscopically and histologically at 17 different time points ranging from 0-180d (N= 120 axolotls). At 12h the wound's surface was smoothened and within 1mm, internal lingual muscular modifications occurred; at the same distance, between days 4-7 lingual muscle degradation was complete. Immunofluorescence indicates complete keratinocytes migration by 48h. These cells with epidermal Leydig cells, appearing yellow, lead the chin's deep tissue outgrowth until its closure on the 14 th day. Regeneration speeds varied and peaked in time for each tissue, 1) deep Immunofluorescence toCol IV showed basement membrane reconnected between days 30-45 coinciding with the chin's dermal tissue's surface area recovery. New muscle appeared at 21d and was always preceded by the formation of a collagen bed. Both chin tissues regain all surface area and practically all components while the lingual structure lacks some content but is generally similar to the original.The methodology and high-resolution observations described here are the first of its kind for this animal model and could serve as a basis for future studies in oral and facial regenerative research.3

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Free perforating branch flap for primary repairing the huge soft-tissue defects on the scalp and face

Wang

et al. 2016

Journal of Dermatological Treatment

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Reconstruction of Soft Tissue Defects Using Microsurgical Flaps

Cited by 3 publications

References 23 publications

Depth of Invasion: Influence of the Latest TNM Classification on the Prognosis of Clinical Early Stages of Oral Tongue Squamous Cell Carcinoma and Its Association with Other Histological Risk Factors

Depth of Invasion: Influence of the Latest TNM Classification on the Prognosis of Clinical Early Stages of Oral Tongue Squamous Cell Carcinoma and Its Association with Other Histological Risk Factors

Oral‐Facial Tissue Reconstruction in the Regenerative Axolotl

Free perforating branch flap for primary repairing the huge soft-tissue defects on the scalp and face

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