Faculty Collaboration Database

Application of contemporary reconstructive techniques in head and neck surgery for anterior oral-facial cancers. Surgery 1976 Sep;80(3):373-8

Date

09/01/1976

Pubmed ID

960004

Scopus ID

2-s2.0-0017197704 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

One hundred and seventy-eight patients underwent surgical therapy for oral and cervical cancers from 1964 to 1975. About 25 percent of the patients underwent neck dissection and/or "pull-through" procedures. However, majority of patients required a spectrum of reconstructive techniques extending from marginal mandibulectomy with or without skin flaps (39), partial mandibulectomy with immediate prosthetic mandible reconstruction (36), to extended resections with skin flaps or staged reconstructive procedures (48). The advantages and disadvantages of each reconstructive procedure have been observed and a scheme of graded management has been developed. The therapeutic goal is to maximize functional oral reconstruction without compromising tumor cure. There were two operative deaths--one from myocardial infarction after operation and one from halothane hepatitis. The tumors were grouped according to TNM classification. In the follow-up of the 178 patients, 47 per cent are known to be alive and free of tumor. The better results (greater than 70% free of tumor) are in the group with smaller tumors (less than 2 cm.) and no node involvement, and there are less favorable rates for those patients with larger tumors and nodal metastasis or invasion of adjacent structures. There was a 49 percent 2 year survival rate and 12 of the deaths were from nontumor causes. Ninety percent of these patients smoked more than one pack of cigarettes per day, accounting for the high rate of synchronous or subsequent oroairway cancers (7 percent). Seventy-five percent were considered to be "heavy alcoholics" with evidence of cirrhotic liver disease. These two factors significantly decreased the survival from rate 54 to 47 percent. The series shows that planned primary reconstructive surgery can be done at a low risk, that it can enhance resectability of head and neck cancers, and that it does improve oral function after operation.

Author List

Joyce LD, McQuarrie DG

MESH terms used to index this publication - Major topics in bold

Adenocarcinoma
Adult
Aged
Alcoholism
Carcinoma, Basal Cell
Carcinoma, Squamous Cell
Head and Neck Neoplasms
Humans
Lymph Node Excision
Mandible
Mandibular Prosthesis
Melanoma
Middle Aged
Mouth Neoplasms
Neck
Neoplasms, Multiple Primary
Smoking
Surgery, Plastic