The use of computed tomography in assessing oral cancer recurrence after flap reconstruction

Following radiation treatment, ablative surgery, and surgical flap reconstruction in cases of oral cancer, postoperative follow-up for oral cancer recurrence presents a difficult task. Computed tomography (CT) remains the most accessible method of postoperative assessment; however, it has yet to be conclusively shown to provide an advantage over an adequate history and physical examination. Twenty-four consecutive patients who had undergone flap reconstruction of the oral cavity for advanced or radiorecurrent disease were studied over an 18-month period. Eight patients showed no evidence of recurrent tumor either clinically or by CT scan. Eleven patients had evidence of recurrent disease clinically, which was confirmed by CT. In four patients, clinically unsuspected regional recurrent tumor was revealed by CT. One false negative scan was encountered. CT proved to be a sensitive modality for detecting clinically unsuspected recurrences, particularly regional recurrences.