Retrospectively, 101 OTSCC patients with SIF reconstruction were enrolled. Oncological outcomes included the total locoregional recurrence, the SIF related locoregional recurrence (SRLR) which referred to the local recurrence at flap and ipsilateral neck recurrence at level I, recurrence free survival (RFS), overall survival (OS), and disease specific survival (DSS).
Sixty-one patients were pathologically node-negative (pN0) and 40 were pN+. Thirteen patients experienced locoregional recurrence, of which 5 had a SRLR. The pN+ group had a significantly higher locoregional recurrence rate, lower 5-year RFS, OS and DSS than pN0 group (P < 0.05). Patients with pN0 had a significantly higher neck RFS when compared to those with pN+ either at level I (P = 0.005) or at other levels (P < 0.001). However, the neck RFS was similar between the two subgroups of pN+ (P = 0.550). Especially, patients with pN+ at level I had a significantly higher SRLR rate (P = 0.006) compared to those with pN0 at level I. Multivariate analysis showed that pN+ was an unfavorable factor for tumor recurrence and OS.
Our data did not support the use of SIF in OTSCC patients with pN+ neck at level I due to an significantly increased SRLR rate compared to those with pN0 neck at level I.
方法:回顾,101例OTSCC患者进行SIF重建。肿瘤结果包括总局部复发,SIF相关的局部复发(SRLR)指的是皮瓣局部复发和同侧颈部I级复发,无复发生存率(RFS),总生存期(OS),和疾病特异性生存(DSS)。
结果:61例病理淋巴结阴性(pN0),40例pN+。13例患者出现局部复发,其中5个有SRLR。pN+组局部复发率明显较高,较低的5年期RFS,OS和DSS优于pN0组(P<0.05)。在I级(P=0.005)或其他水平(P<0.001)下,pN0患者的颈部RFS明显高于pN患者。然而,两个pN+亚组的颈部RFS相似(P=0.550).尤其是,与I级pN0患者相比,I级pN+患者的SRLR率明显更高(P=0.006)。多因素分析显示,pN+是肿瘤复发和OS的不利因素.
结论:我们的数据不支持在I级pN+颈部OTSCC患者中使用SIF,因为与I级pN0颈部患者相比,SRLR率显着增加