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口腔早期鳞状细胞癌的游离皮瓣重建——一项评估肿瘤学结局和生活质量的前瞻性单中心试验

Free-Flap Reconstruction in Early-Stage Squamous Cell Carcinoma of the Oral Cavity-A Prospective Monocentric Trial to Evaluate Oncological Outcome and Quality of Life.

作者信息

Moratin Julius, Zittel Sven, Horn Dominik, Behnisch Rouven, Ristow Oliver, Engel Michael, Hoffmann Jürgen, Freier Kolja, Freudlsperger Christian

机构信息

Department of Oral and Cranio-Maxillofacial Surgery, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.

Department of Oral and Cranio-Maxillofacial Surgery, Saarland University Medical Center, Kirrberger Straße, 66424 Homburg, Germany.

出版信息

J Clin Med. 2023 Jul 22;12(14):4833. doi: 10.3390/jcm12144833.

Abstract

Surgery is generally accepted as standard treatment in oral cancer, but the reconstructive procedures remain a matter of debate. The aim of this study was to evaluate oncological outcome and quality of life following surgical resection and free-flap reconstruction in patients with early oral squamous cell carcinoma. The presented trial was performed as a prospective, single-center observation study. Inclusion criteria were primary surgery in early-stage oral squamous cell carcinoma with free-flap reconstruction. Endpoints were overall and progression-free survival and quality of life up to 24 months after surgery. Twenty-six patients were included. Overall survival was 100% and progression-free survival was 92.3% in a maximum follow-up time of 21 months. Global quality of life showed no significant alteration after surgery. Patients reported a significant reduction in pain ( = 0.048) and a decreasing impairment of speech one year after surgery ( = 0.021). Free-flap reconstruction is a safe procedure that results in excellent oncological outcome and quality of life. Functional outcome is of high relevance in early-stage tumors of the head and neck and may mostly be affected by reconstructive procedures. Therefore, a prospective evaluation to explore success and the effects of surgical therapy is highly warranted.

摘要

手术通常被认为是口腔癌的标准治疗方法,但重建手术仍存在争议。本研究的目的是评估早期口腔鳞状细胞癌患者手术切除和游离皮瓣重建后的肿瘤学结局和生活质量。本试验作为一项前瞻性、单中心观察性研究进行。纳入标准为早期口腔鳞状细胞癌行游离皮瓣重建的初次手术。终点指标为术后24个月内的总生存率、无进展生存率和生活质量。纳入26例患者。在最长21个月的随访时间内,总生存率为100%,无进展生存率为92.3%。术后全球生活质量无显著改变。患者报告术后疼痛显著减轻(P = 0.048),术后一年言语障碍减轻(P = 0.021)。游离皮瓣重建是一种安全的手术方法,可产生良好的肿瘤学结局和生活质量。功能结局在早期头颈部肿瘤中具有高度相关性,且可能主要受重建手术的影响。因此,非常有必要进行前瞻性评估以探讨手术治疗的成功率和效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/10381471/c9d1439c9fa0/jcm-12-04833-g001.jpg

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