Abstract
Objective: Provide prognostic data for the physicians and patients when a decision is made for primary or salvage ablative surgery of the upper aerodigestive tract with the aide of microvascular reconstruction.
Method: Retrospective chart review of patients with primary or recurrent upper aerodigestive tract squamous cell carcinoma treated with free flap reconstruction between 1993 and 2009. Prior treatment, recurrence time and site, sex, age, complications, cause of death, stage, and survival rates were analyzed.
Results: A total of 219 patients were identified. Mean age was 59.6 years. A total of 136 patients underwent primary resection with immediate reconstruction, 83 patients underwent salvage treatment. A total of 196 patients had advanced clinical stage oral (n = 129) and oropharyngeal squamous cell carcinomas (n = 51). Median overall survival for all patients was 21.7 months (CI 16.2, 33.1) with median recurrence free survival of 12.6 months (CI 8.8, 16.6). Median overall survival was 31.3 months (CI 18.6, 48.6) for primary resection group and 14.6 months for salvage group (CI 11.4, 21.5). Recurrence free median survival was 16.6 months for the primary resection group and 7.7 months for salvage group (P = .009).
Conclusion: The surgeon and the patient need to be aware of survival rates, when radical resection with free flap reconstruction offered; especially in salvage setting. This may help the patient and the surgeon in choosing the most suitable treatment modality for any given condition.
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