OBJECTIVE: This study aimed to assess the efficacy and safety of facial artery musculomucosal (FAMM) flap for small-medium tongue or floor of mouth defects caused by surgical resection of early-medium stage tongue or floor of mouth cancer.
METHODS: A retrospective cohort study was conducted and included patients with early-medium stage tongue or floor of mouth cancer and reconstructed by FAMM flap or traditional free or axial flaps. Demographic data and surgery-related data were collected. Patients were followed up for 6 months and evaluated with satisfaction, maximal mouth opening, satisfactory contour and speech, and oral intake function at months 3 and 6.
RESULTS: Forty-five patients were included, with 15 in the FAMM group and 30 in the flap group. All patients finished 3 months follow-up, and 1 in each group was lost to follow-up at month 6. All followed-up patients had no recurrence or metastasis. The FAMM group had a significantly shorter surgical time than the flap group (P<0.05). The flap group had significantly more donor sites that were uncomfortable compared with the FAMM group (P<0.05). There was no statistical significance on satisfaction, but the FAMM group had better outcomes on contour, speech, and oral intake function at month 6 than the flap group (P<0.05). The FAMM group had smaller maximal mouth opening than the flap group (P<0.05) at month 3 but equivalent maximal mouth opening at month 6 (P>0.05).
CONCLUSIONS: FAMM flap has some advantages for small-medium tongue or floor of mouth defects caused by surgical resection of early-medium stage tongue or floor of mouth cancer, and it could be an ideal choice for clinical application.
目的: 探究以面动脉为蒂的黏膜肌（FAMM）瓣在修复临床早-中期舌癌及口底癌缺损中的临床效果及安全性。方法: 通过回顾性队列研究的方式纳入使用FAMM瓣（FAMM组）或者皮瓣（皮瓣组）修复早-中期舌癌、口底癌切除后中小型舌、口底缺损的患者，收集患者一般资料及相关手术资料，术后3个月和6个月评估患者满意度、张口度、外形满意度、语音满意度以及进食功能情况。结果: 本研究共纳入患者45名，其中FAMM组15名，皮瓣组30名。所有患者均完成了术后3个月随访，2组各1名患者在术后6个月失访，随访到的患者没有复发及转移征象。FAMM组手术时间短于皮瓣组（P<0.05）。皮瓣组患者术后供瓣区不适多于FAMM组（P<0.05）。2组患者术后总体满意度差异无统计学意义（P>0.05），但FAMM组术后6个月外形满意度、语音满意度和进食功能优于皮瓣组（P<0.05）；术后3个月张口度FAMM组小于皮瓣组（P<0.05），但术后6个月2组差异无统计学意义（P>0.05）。结论: FAMM瓣修复早-中期舌、口底癌切除后中小型的舌、口底缺损具有一定的优势，可以在临床中考虑使用。.

Objective To describe the determinants of survival for patients with floor of mouth (FOM) squamous cell carcinoma (SCC) from 1973 to 2013 with the SEER database (Surveillance, Epidemiology, and End Results). Study Design and Setting Retrospective cohort study with a national database. Subjects and Methods The SEER registry was utilized to calculate survival trends for patients with FOM SCC between 1973 and 2013. Patient data were analyzed with respect to age, sex, race, primary site, stage at presentation, tumor size, grade, and treatment modalities (surgery and radiotherapy). Overall survival (OS) and disease-specific survival (DSS) were calculated. Results A total of 14,010 FOM SCC cases were identified. The cohort was 69.5% male, and the median age at diagnosis was 62 years. Forty-six percent of cases were treated with surgery, while 14% received radiotherapy. Kaplan-Meier analysis demonstrated OS and DSS of 39% and 59% at 5 years, respectively. Multivariate analysis showed that age, grade, stage, size, and surgery were determinants for OS and DSS (all P < .05). For early- and advanced-stage cancers, age, grade, size, and surgery predicted OS and DSS, while radiotherapy was a predictor of OS and DSS in advanced-stage tumors only (all P < .05). Conclusion To our knowledge, this study is the largest to date investigating prognostic factors for survival of patients diagnosed with FOM SCC. Determinants of survival include age, grade, stage, size, and surgery. Surgery appears to play a critical role in the management of these tumors.