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Wu X, Yang R, Yuan Y, Xiong Y, Su T, Jiang C, Jian X, Guo F. Application of a chimeric ALT perforator flap with vastus lateralis muscle mass in the reconstruction of the defects after radical resection of a buccal carcinoma: A retrospective clinical study. J Surg Oncol 2020; 122:632-638. [PMID: 32830325 DOI: 10.1002/jso.25926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 03/25/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVES Aggressive resection of buccal cancer simultaneously leaves both oral and lateral facial defects. It is unknown whether a perforator-based chimeric anterolateral thigh (ALT) flap, with a muscular component, is suitable for the reconstruction of these complicated defects. METHODS In this retrospective study, 48 patients with a buccal carcinoma (T2 N0-1 M0), who underwent extensive surgical resection, were enrolled. Twenty-seven cases underwent reconstruction using the classical ALT perforator flap (classical group), and 21 cases used the chimeric ALT perforator flap with vastus lateralis muscle mass (chimeric group). The incidence of wound infection, lower limb extremity function, facial appearance, survival curves, and quality of life were compared between groups. RESULTS The incidence of wound infection or effusion was lower in the chimeric group than in the classical group. The aesthetic result achieved in the chimeric group was better than in the classical group. Meanwhile, there was no significant difference in the function of the donor site between groups. CONCLUSIONS The chimeric ALT perforator flap, with a muscular component, can reconstruct both the oral and lateral face defects accurately. It sustains the profile of the lateral face and decreases the incidence of wound infection.
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Affiliation(s)
- Xiaoshan Wu
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Institute of Oral Precancerous Lesions, Central South University, Changsha, Hunan, China
| | - Rong Yang
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yongxiang Yuan
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Institute of Oral Precancerous Lesions, Central South University, Changsha, Hunan, China
| | - Yafei Xiong
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Tong Su
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Institute of Oral Precancerous Lesions, Central South University, Changsha, Hunan, China
| | - Canhua Jiang
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Institute of Oral Precancerous Lesions, Central South University, Changsha, Hunan, China
| | - Xinchun Jian
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Institute of Oral Precancerous Lesions, Central South University, Changsha, Hunan, China
| | - Feng Guo
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Institute of Oral Precancerous Lesions, Central South University, Changsha, Hunan, China
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Zhang Y, Zheng L, Quan L, Du L. Prognostic role of platelet-to-lymphocyte ratio in oral cancer: A meta-analysis. J Oral Pathol Med 2019; 50:274-279. [PMID: 30681182 DOI: 10.1111/jop.12832] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/20/2018] [Accepted: 01/03/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Platelet-to-lymphocyte ratio (PLR) has been suggested to be associated with the progression of oral cancer with inconclusive results. The objective of the current study was to assess the prognostic role of oral cancer by meta-analysis. METHOD PubMed, EMbase(Ovid), CNKI, WanFang Data, VIP, and CBM databases were searched up to August 24, 2018. Studies investigating the association between PLR and progression of oral cancer were included. Meta-analysis was performed by using Revman 5.3 software. The protocol of the study was registered on PROSPERO (CRD42018106836). RESULTS A total of five studies were included in the meta-analysis. The results of the meta-analysis showed that higher PLR was associated with the poor progress of oral cancer (overall survival: OR = 2.06, 95 CI: 1.49-2.86, P < 0.0001; disease-specific survival: OR = 2.12, 95 CI: 1.59-2.82, P < 0.00001). CONCLUSION The current meta-analysis showed that higher PLR is a poor progression factor for oral cancer. However, larger sample, multi-center studies should be carried out in the future to validate the above conclusion.
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Affiliation(s)
- Yonggang Zhang
- Department of Periodical Press and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Linli Zheng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Liuliu Quan
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Liang Du
- Department of Periodical Press and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
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Cariati P, Cabello Serrano A, Marin Fernandez A, Julia Martinez MA, Fernandez Solis J, Martinez Lara I. Behavior of Buccal Mucosal Squamous Cell Carcinoma: A Retrospective Study of 53 Carcinomas of This Anatomical Region. Craniomaxillofac Trauma Reconstr 2018; 12:8-13. [PMID: 30815209 DOI: 10.1055/s-0038-1668583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 07/07/2018] [Indexed: 10/28/2022] Open
Abstract
The main aim of the present report is to study the pattern of distribution of cervical metastasis in buccal mucosa cancer and to discuss the various therapeutic options available. Fifty-three patients with squamous cell carcinoma of the buccal mucosa treated with tumorectomy and selective neck dissection were included in the study. We also studied the relationship between specific pathological features and overall survival. Level Ib was the most affected level, followed by level IIa. T stage, N stage, N involvement tumor thickness, extracapsular spread (ECS), and vascular invasion were associated with poorer outcomes regarding overall survival ( p < 0.001). Carcinoma of the buccal mucosa should be treated aggressively from the early stages. A large tumorectomy of the primary tumor is required to reduce the number of local recurrences. Moreover, we recommend performing a supraomohyoid neck dissection even in cT1N0 if there is a suspicion that the tumor thickness may be greater than 0.4 cm. The high risk of local recurrence obliges protection of the neck from a future cervical recurrence even in T1 small tumors. This could reduce the risk of cervical involvement during the follow-up and improve overall survival rates.
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Affiliation(s)
- Paolo Cariati
- Cirugia Oral y Maxilofacial, Hospital Universitario Virgen de las Nieves, Granada, Andalucia, Spain
| | - Almudena Cabello Serrano
- Cirugia Oral y Maxilofacial, Hospital Universitario Virgen de las Nieves, Granada, Andalucia, Spain
| | - Ana Marin Fernandez
- Cirugia Oral y Maxilofacial, Hospital Universitario Virgen de las Nieves, Granada, Andalucia, Spain
| | | | - Jose Fernandez Solis
- Cirugia Oral y Maxilofacial, Hospital Universitario Virgen de las Nieves, Granada, Andalucia, Spain
| | - Ildefonso Martinez Lara
- Cirugia Oral y Maxilofacial, Hospital Universitario Virgen de las Nieves, Granada, Andalucia, Spain
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Cariati P, Perez de Perceval Tara M, Fernandez Solis J, Martinez Lara I. [Factors that influence the diagnostic delay of oral cancer]. Semergen 2018; 44:e105-e106. [PMID: 29773307 DOI: 10.1016/j.semerg.2018.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 02/28/2018] [Accepted: 03/15/2018] [Indexed: 11/29/2022]
Affiliation(s)
- P Cariati
- Departamento de Cirugía Oral y Maxilofacial, Hospital Virgen de las Nieves, Granada, España.
| | | | - J Fernandez Solis
- Departamento de Cirugía Oral y Maxilofacial, Hospital Virgen de las Nieves, Granada, España
| | - I Martinez Lara
- Departamento de Cirugía Oral y Maxilofacial, Hospital Virgen de las Nieves, Granada, España
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Cervical metastases behavior of T1-2 squamous cell cancer of the oral mucosa. Clin Oral Investig 2016; 21:931-935. [PMID: 27183826 DOI: 10.1007/s00784-016-1845-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 05/02/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The clinical management of the neck of patients with early-stage oral squamous cell cancer (OSCC) is still controversially discussed in the current literature. This study analyzes histo-clinical factors influencing the occurrence of cervical lymph node metastases (CM). MATERIALS AND METHODS In a retrospective mono-center study, patients with a primary T1-2 OSCC between 2000 and 2014 were analyzed regarding histo-clinical parameters possibly influencing the CM rate and the outcome. RESULTS Two hundred eighty-five patients (66 %) were male and 146 female (44 %), with a mean age of 60 ± 12 years at the time of diagnosis. Seventy-seven percent showed a positive risk profile (nicotine/alcohol) and 69 % underlying diseases. Forty-four percent of the patients were staged as T2 (30 % with CM). Advanced tumor size (T1 vs. T2) and grading (G1-2 vs. G3) were statistically significantly (p < 0.001) associated with the occurrence of CM. The localization within the oral cavity, age, gender, risk profile, or underlying diseases had no influence on CM occurrence. During the follow-up, tumor size (p = 0.001), CM (p < 0.001), and tumor relapse (p < 0.001) were significantly associated with a worse outcome. CONCLUSIONS Early-stage OSCC showed aggressive lymphatic metastatic behavior that depends on the size and the grading of the tumor. CLINICAL RELEVANCE A watch-and-wait policy as the primary management for cN0 may likely be inferior to a selective neck dissection for this patient group and should only be considered for very small tumors with a good differentiation.
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Saruhanoğlu A, Ergun S, Kaya M, Warnakulasuriya S, Erbağcı M, Öztürk Ş, Deniz E, Özel S, Çefle K, Palanduz Ş, Tanyeri H. Evaluation of micronuclear frequencies in both circulating lymphocytes and buccal epithelial cells of patients with oral lichen planus and oral lichenoid contact reactions. Oral Dis 2013; 20:521-7. [DOI: 10.1111/odi.12169] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 03/25/2013] [Accepted: 07/11/2013] [Indexed: 12/24/2022]
Affiliation(s)
- A Saruhanoğlu
- Faculty of Dentistry Department of Oral Surgery Istanbul University Istanbul Turkey
| | - S Ergun
- Faculty of Dentistry Department of Oral Surgery Istanbul University Istanbul Turkey
| | - M Kaya
- Medical Genetics Programme at the Institute of Health Sciences Istanbul University Istanbul Turkey
| | | | - M Erbağcı
- Medical Genetics Programme at the Institute of Health Sciences Istanbul University Istanbul Turkey
| | - Ş Öztürk
- Faculty of Medicine Division of Medical Genetics Department of Internal Medicine Istanbul University Istanbul Turkey
| | - E Deniz
- Faculty of Dentistry Department of Oral Surgery Yeditepe University Yeditepe Turkey
| | - S Özel
- Faculty of Medicine Department of Biostatistics and Medical Informatics Istanbul University Istanbul Turkey
| | - K Çefle
- Faculty of Medicine Division of Medical Genetics Department of Internal Medicine Istanbul University Istanbul Turkey
| | - Ş Palanduz
- Faculty of Medicine Division of Medical Genetics Department of Internal Medicine Istanbul University Istanbul Turkey
| | - H Tanyeri
- Faculty of Dentistry Department of Oral Surgery Istanbul University Istanbul Turkey
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Bombeccari GP, Guzzi G, Tettamanti M, Giannì AB, Baj A, Pallotti F, Spadari F. Oral lichen planus and malignant transformation: a longitudinal cohort study. ACTA ACUST UNITED AC 2011; 112:328-34. [PMID: 21782485 DOI: 10.1016/j.tripleo.2011.04.009] [Citation(s) in RCA: 97] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 04/03/2011] [Accepted: 04/13/2011] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Oral lichen planus (OLP) is associated with risk for developing oral squamous cell carcinoma (OSCC). We performed a 7-year prospective study to assess the incidence of malignant transformation of OLP among adults. STUDY DESIGN Three hundred twenty-seven OLP patients, 229 women (70.0%) and 98 men (30.0%), were observed during the follow-up period. RESULTS During a mean follow-up of 81.7 months, 8 of 327 patients developed an OSCC in OLP areas (0.36%/y), yielding the high overall standardized incidence ratio of 17.7 (95% confidence interval [CI] 8.8-35.3). The standardized incidence ratio for OSCC was significantly higher in women [27.0 (95% CI 11.2-64.8)] than in men [11.2 (95% CI 3.6-34.9)]. Six OSCCs were well differentiated (75%) and 2 moderately differentiated (25%). Three subjects (37.5%) developed recurrences within 2 years (mean 16.1 ± 3.5 months). Disease-free survival rate after 69.8 months was 97.3%. CONCLUSIONS OLP was associated with a significant increase in the risk for OSCC. Close surveillance may help to reduce the morbidity of OSCC arising from OLP at 24 months.
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Affiliation(s)
- Gian Paolo Bombeccari
- Unit of Oral Pathology and Medicine, Department of Reconstructive and Diagnostic Surgical Sciences, University of Milan, Milan, Italy.
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