Patterns of local recurrence after curative resection and reconstruction for oropharyngeal and oral cancers: Implications for postoperative radiotherapy target volumes

Head Neck. 2019 Nov;41(11):3916-3923. doi: 10.1002/hed.25928. Epub 2019 Aug 20.

Abstract

Background: We aimed to determine the patterns of local recurrence after curative resection and reconstruction for oropharyngeal and oral cancers.

Methods: One hundred-fourteen patients with oropharyngeal and oral cancers underwent resection and reconstruction. The local recurrences were classified as "intra-flap" (the recurrent tumor was located in the flap tissue), "marginal" (≤5 mm from the flap anastomosis), and "outside" (in the original tissue and >5 mm from the anastomosis) recurrences.

Results: Twenty-seven patients (23.7%) experienced local recurrence, while 32 (28.1%) experienced regional, and nine (7.9%) recurred distantly. Among those who showed local recurrence, one developed "outside" recurrence and the remaining 26 developed "marginal" recurrences. Age >60 years and lymph node metastasis were associated with poor disease-free survival and overall survival (OS), while the perineural invasion was related to poor locoregional failure-free survival and OS.

Conclusion: Most recurrences developed at the anastomosis marginal site, while none developed in the flap tissue.

Keywords: oral cancer; oropharyngeal cancer; reconstruction; recurrence; surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mouth Neoplasms / mortality
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / surgery*
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / radiotherapy
  • Neoplasm Staging
  • Oropharyngeal Neoplasms / mortality
  • Oropharyngeal Neoplasms / pathology
  • Oropharyngeal Neoplasms / surgery*
  • Plastic Surgery Procedures
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Young Adult