Total Glossectomy With Free Flap Reconstruction: Twenty‐Year Experience at a Tertiary Medical Center
| Autor: | Karam W. Badran, Edward C. Kuan, Albert Y Han, Miguel Fernando Palma Diaz, Maie A. St. John, Jon Mallen-St. Clair, Keith E. Blackwell |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Radiography Salvage therapy Free Tissue Flaps Tertiary Care Centers 03 medical and health sciences 0302 clinical medicine Swallowing Tongue Total glossectomy medicine Humans Fibula 030223 otorhinolaryngology Aged Retrospective Studies Aged 80 and over Glossectomy business.industry Middle Aged Tongue Neoplasms Surgery Treatment Outcome medicine.anatomical_structure Otorhinolaryngology 030220 oncology & carcinogenesis Free flap reconstruction Female Base of tongue cancer business |
| Zdroj: | The Laryngoscope. 129:1087-1092 |
| ISSN: | 1531-4995 0023-852X |
| DOI: | 10.1002/lary.27579 |
| Popis: | Objectives/hypothesis To characterize the demographics, clinicopathologic characteristics, and treatment and reconstructive outcomes of patients who underwent total glossectomy STUDY DESIGN: Retrospective chart review at an academic tertiary-care medical center. Methods All patients who had undergone total glossectomy (as an individual procedure or as part of a more extensive resection) between January 1, 1995 and December 31, 2014 were included in the analysis. Patient characteristics and clinical outcomes were reviewed. Results Forty-eight patients underwent total glossectomy for oral tongue and base of tongue cancer. The mean age of the patients was 56 (range, 29-92 years). History of tobacco and heavy alcohol use was found in 76% and 11% of patients, respectively. The majority of patients had advanced cancer (91.7% at stage IV), and 60.4% had salvage therapy for recurrent disease. T4 disease comprised 81% of patients. Sixty percent had clinical or radiographic evidence of nodal metastasis. Reconstruction of the defect was performed with free flaps from the rectus abdominus (40%), fibula (25%), anterolateral thigh (23%), and other donor tissues. One- and 5-year survival rates were 42% and 26%, with locoregional and distant recurrence reported at 36% and 25%, respectively. Conclusions Total glossectomy for oncologic control is most commonly performed in patients who have stage IV cancers. Despite high reconstructive success rates, the likelihood of locoregional and distance recurrence was high. Most patients can communicate intelligibly and achieve decannulation, but swallowing outcomes remain guarded, especially considering previous irradiation and resection of the base of tongue. Level of evidence 4 Laryngoscope, 129:1087-1092, 2019. |
| Databáze: | OpenAIRE |
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