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Analysis of recurrence and survival after hypopharyngeal ablative surgery with radial forearm free flap
Joseph Scharpf1, Ramon M Esclamado
1Head and Neck Institute, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Objectives/Hypothesis:
To address the controversial acceptable distal resection margin for the surgical management of patients with hypopharyngeal cancer.
Study Design:
Retrospective review of the records of 28 consecutive patients who underwent pharyngoesophagectomy and reconstruction with radial forearm free flaps between 1996 to 2001.
Methods:
The Kaplan-Meier method was used to estimate survival and recurrence-free time.
Results:
The minimum follow-up time was 2 years, and there were 14 (50%) patients who had recurrences. Analysis revealed that only one (3%) patient experienced a recurrence at the inferior resection margin, the junction of the free flap reconstruction, and the cervical esophagus. Estimated 4 year survival was 48.5%.
Conclusions:
Total laryngopharyngectomy and partial esophagectomy with radial forearm free flap reconstructions in appropriately selected patients with hypopharyngeal cancer does not compromise local recurrence rates at the distal esophageal margin.
