Gerardo Petruzzi: Department of Otolaryngology, Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy..
Department of Otolaryngology - Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy. .
Acta Biomed. 2023 Aug 3;94(4):e2023173. doi: 10.23750/abm.v94i4.14674.
Free flaps or pedicle flaps are the mainstay of cancer surgery in the head and neck area. However, their long-term sequelae are still poorly understood. Among these, the development of a secondary primary tumor on a flap is a rare and uncertain reported event. Methods: A computer-aided systematic literature search was performed by using the PubMed, EMBASE and Cochrane Library databases. A systematic review of the literature, following the PRISMA checklist, was carried out with the aim of analyzing all the citations reporting this second primary, with attention to risk factors, behavior, etiological causes. Results: Overall, 27 cases of second primary squamous cell carcinoma arising on a pedicle or free flap were identified. In addition, other three cases were discussed. Conclusions: Persistent exposure to oral stimuli such saliva, oral microbiome, smoke or a colonization by the adjacent mucosa were considered as a possible cause of second primary carcinoma. Although rare, a new neoplasm onset should know and considered as a new concept in the follow-up of patients undergoing reconstruction with free or pedicle flaps.
游离皮瓣或带蒂皮瓣是头颈部癌症手术的主要方法。然而，其长期的后遗症仍知之甚少。其中，皮瓣上发生继发性原发性肿瘤是一种罕见且不确定的报道事件。
通过使用 PubMed、EMBASE 和 Cochrane Library 数据库进行计算机辅助系统文献检索。按照 PRISMA 清单进行系统的文献回顾，旨在分析所有报告这种第二原发性肿瘤的引文，重点关注危险因素、行为、病因。
总共确定了 27 例发生在带蒂或游离皮瓣上的第二原发性鳞状细胞癌，此外还讨论了另外 3 例病例。
持续暴露于口腔刺激物（如唾液、口腔微生物群、烟雾或相邻黏膜的定植）被认为是第二原发性癌的可能原因。虽然罕见，但在接受游离皮瓣或带蒂皮瓣重建的患者的随访中，应该了解并考虑新的肿瘤发病作为新概念。
