José Carlos Marques de Faria

Publications (1)0 Total impact

• Article: Which oral cancer patients benefit the most from microsurgical reconstruction?

  Mônica Lúcia Rodrigues, Hugo Fontan Köhler, José Magrin, Alexsander Bressan, José Carlos Marques de Faria, Luiz Paulo Kowalski
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  ABSTRACT: The objective of this study is to evaluate the impact of microsurgical reconstruction on local recurrence rates and disease-specific survival in patients with oral squamous cell carcinoma. This study is a retrospective review of patients treated at a tertiary cancer center. Six hundred and five patients were included in this study with 529 males (87.44%) and 76 females (12.56%). These were composed of 467 (77.19%) pedicled-flaps reconstructions and 138 (22.81%) free-flap procedures. There was no difference between the groups regarding T stage, N stage, or type of oncological surgery. Use of postoperative radiotherapy was more common in the free-flap group with a significantly shorter time interval than the pedicled-flap group. Free-flap patients had a lower proportion of compromised/close surgical margins (p < 0.0001). Univariate analysis disclosed as significant for local recurrence: gender, T stage, microsurgical reconstruction, lymphatic embolization, neural infiltration, and surgical margins. In a multivariate model, T stage (p < 0.001), neural infiltration (p < 0.001), and microsurgical reconstruction (p < 0.001) remained significant. Significant factors for survival in univariate analysis were: gender, T stage, N stage, synchronous neck dissection, microsurgical reconstruction, lymphatic embolization, neural infiltration, and surgical margins. In a multivariate analysis, T stage (p < 0.001), N stage (p < 0.001), synchronous neck dissection (p = 0.025), microsurgical reconstruction (p < 0.001), lymphatic embolization (p = 0.023), and neural infiltration (p < 0.001) remained significant. Regression trees show a significant impact of free flaps in T3/T4 primary tumors. Use of microsurgical flaps provides a significant improvement in local recurrence and survival in patients with T3–T4a primary tumors. It also reduces the interval between surgery and radiotherapy. KeywordsMouth neoplasms–Neoplasm recurrence, local–Microsurgery–Prognosis
  European Journal of Plastic Surgery 04/2012; 34(2):75-80.