Comparison of long-term outcomes between pull-through resection and mandibular lip-split surgery for T4a tongue/floor of mouth cancers
Journal
Head and Neck
Journal Volume
40
Journal Issue
1
Pages
144-153
Date Issued
2018
Author(s)
Abstract
Background: The purpose of this study was to determine whether the pull-through resection is better than the mandibular lip-split for advanced tongue/floor of mouth (FOM) cancers, which remains inconclusive. Methods: A retrospective cohort study was performed on 91 patients with T4a tongue/FOM cancers from 2009 to 2014. Cases with mandibular resection were excluded. The pull-through resection was used when the mouth opening was ?15 mm; otherwise the mandibular lip-split was used. Results: Fifty-eight patients received pull-through resections and 33 underwent mandibular-lip splits and the mean follow-up periods were 42 and 45 months, respectively. Surgical margin, locoregional recurrence, and 5-year survival were similar between the 2 groups. The pull-through approach had a significantly shorter operation time, lower rates of flap infection, osteoradionecrosis, metal plate exposure, loss of tooth vitality, and better aesthetics. Conclusion: Our data suggest that the pull-through resection does not compromise disease control for advanced tongue/FOM cancers and is superior to the mandibular lip-split in terms of operation time, postoperative complications, and aesthetics. ? 2017 Wiley Periodicals, Inc.
SDGs
Other Subjects
adult; aged; Article; bone necrosis; cancer recurrence; cohort analysis; controlled study; esthetics; female; follow up; human; infection; intermethod comparison; major clinical study; male; mandible resection; mandibular lip split surgery; mouth cancer; mouth floor; operation duration; outcome assessment; postoperative complication; priority journal; pull through operation; retrospective study; surgical margin; surgical technique; survival analysis; tongue cancer; cancer staging; cancer survivor; comparative study; disease free survival; evaluation study; glossectomy; head and neck tumor; mandible osteotomy; middle aged; mortality; mouth floor; nonparametric test; pathology; procedures; risk assessment; squamous cell carcinoma; Taiwan; time factor; tongue tumor; tumor invasion; tumor recurrence; Adult; Aged; Cancer Survivors; Carcinoma, Squamous Cell; Cohort Studies; Disease-Free Survival; Female; Follow-Up Studies; Glossectomy; Head and Neck Neoplasms; Humans; Male; Mandibular Osteotomy; Middle Aged; Mouth Floor; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasm Staging; Retrospective Studies; Risk Assessment; Statistics, Nonparametric; Survival Analysis; Taiwan; Time Factors; Tongue Neoplasms
Publisher
John Wiley and Sons Inc.
Type
journal article