Reconstruction in Salvage Surgery for Head and Neck Cancers

Area of Science:

• Head and Neck Surgery
• Surgical Oncology
• Reconstructive Surgery

Background:

• Salvage surgery is crucial for managing recurrences and second primary tumors in head and neck cancers.
• Reconstructive techniques are vital for restoring function and form after oncological resection.
• Understanding outcomes and predictors in salvage reconstruction is essential for improving patient care.

Purpose of the Study:

• To investigate reconstructive options and outcomes in salvage surgery for head and neck cancers.
• To identify predictors of poor reconstructive outcomes in this patient population.

Main Methods:

• Retrospective study of patients undergoing reconstructive flap surgery for head and neck cancer salvage (2004-2017).
• Inclusion criteria: pathology requiring surgical salvage; exclusion: purely reconstructive procedures.
• Analysis of demographical, clinical, and treatment factors as predictors of flap-related complications.

Main Results:

• Ninety-three patients received loco-regional flaps (LRF) and 100 received free flaps (FF).
• Flap-related complications occurred in 17.2% of LRF and 29% of FF groups.
• No statistically significant predictors for flap-related complications were identified in univariate or multivariate analyses.

Conclusions:

• Soft tissue flaps are preferred for salvage reconstruction, even with bony defects.
• The Pectoralis major flap serves a significant role as a "salvage flap" in this context.
• Careful flap selection based on patient and disease factors is critical in salvage head and neck cancer surgery due to common complications.