Pectoralis major myocutaneous flaps vs. revascularised free tissue flaps following salvage surgery for recurrent head and neck cancer. 2022

Jakub Pazdrowski, and Pawel Golusinski, and Mateusz Szewczyk, and Ewa Majchrzak, and Aleksandra Dańczak-Pazdrowska, and Wojciech Golusiński
Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Center, Poznan, Poland.

OBJECTIVE To assess the efficacy of two reconstructive methods: pectoralis major myocutaneous flap and revascularised free flap in salvage surgery for recurrent head and neck cancer. METHODS We retrospectively analysed 100 cases of patients who had recurrent head and neck cancer and were treated in the Department of Head and Neck Surgery between 2011 and 2021. The study participants were divided into two groups depending on the method of reconstruction: 62 patients who underwent revascularised free flap reconstruction and 38 patients with pectoralis major myocutaneous flap. RESULTS In total, flap necrosis was observed in 20 cases, 18 of which were in the group who received revascularised free flaps (29.03%) and 2 in the pectoralis major myocutaneous flap group (5.26%). The OR of flap failure in the free flap group vs. pectoralis major flap group was 7.36 (95% CI 0.85-63.75; p=0.067) In the group who underwent revascularised free flap reconstruction the total surgery time was significantly longer than in the other group (p < 0.0001). CONCLUSIONS We suggest the advantages of using pectoralis major myocutaneous flaps for recurrent head and cancers, which is of the utmost importance for malnourished patients in poor general health and whose primary treatment comprised of a combination therapy.

UI MeSH Term Description Entries
D009364 Neoplasm Recurrence, Local The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site. Local Neoplasm Recurrence,Local Neoplasm Recurrences,Locoregional Neoplasm Recurrence,Neoplasm Recurrence, Locoregional,Neoplasm Recurrences, Local,Recurrence, Local Neoplasm,Recurrence, Locoregional Neoplasm,Recurrences, Local Neoplasm,Locoregional Neoplasm Recurrences,Neoplasm Recurrences, Locoregional,Recurrences, Locoregional Neoplasm
D010369 Pectoralis Muscles The pectoralis major and pectoralis minor muscles that make up the upper and fore part of the chest in front of the AXILLA. Pectoralis Major,Pectoralis Major Muscle,Pectoralis Minor,Pectoralis Minor Muscle,Pectoral Muscle,Muscle, Pectoral,Muscle, Pectoralis,Muscle, Pectoralis Major,Muscle, Pectoralis Minor,Muscles, Pectoralis Major,Pectoral Muscles,Pectoralis Major Muscles,Pectoralis Majors,Pectoralis Minor Muscles,Pectoralis Minors,Pectoralis Muscle
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D006258 Head and Neck Neoplasms Soft tissue tumors or cancer arising from the mucosal surfaces of the LIP; oral cavity; PHARYNX; LARYNX; and cervical esophagus. Other sites included are the NOSE and PARANASAL SINUSES; SALIVARY GLANDS; THYROID GLAND and PARATHYROID GLANDS; and MELANOMA and non-melanoma skin cancers of the head and neck. (from Holland et al., Cancer Medicine, 4th ed, p1651) Cancer of Head and Neck,Head Cancer,Head Neoplasm,Head and Neck Cancer,Head and Neck Neoplasm,Neck Cancer,Neck Neoplasm,Neck Neoplasms,Neoplasms, Upper Aerodigestive Tract,UADT Neoplasm,Upper Aerodigestive Tract Neoplasm,Upper Aerodigestive Tract Neoplasms,Cancer of Head,Cancer of Neck,Cancer of the Head,Cancer of the Head and Neck,Cancer of the Neck,Head Neoplasms,Head, Neck Neoplasms,Neoplasms, Head,Neoplasms, Head and Neck,Neoplasms, Neck,UADT Neoplasms,Cancer, Head,Cancer, Neck,Cancers, Head,Cancers, Neck,Head Cancers,Neck Cancers,Neoplasm, Head,Neoplasm, Neck,Neoplasm, UADT,Neoplasms, UADT
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D058752 Free Tissue Flaps A mass of tissue that has been cut away from its surrounding areas to be used in TISSUE TRANSPLANTATION. Free Flaps,Free Tissue Transfer Flaps,Microsurgical Free Flaps,Flap, Free,Flap, Free Tissue,Flap, Microsurgical Free,Flaps, Free,Flaps, Free Tissue,Flaps, Microsurgical Free,Free Flap,Free Flap, Microsurgical,Free Flaps, Microsurgical,Free Tissue Flap,Microsurgical Free Flap,Tissue Flap, Free,Tissue Flaps, Free
D064827 Myocutaneous Flap A mass of tissue, including skin and muscle, that has been cut away from surrounding areas for transplantation. Musculocutaneous Flap,Flap, Musculocutaneous,Flap, Myocutaneous,Flaps, Musculocutaneous,Flaps, Myocutaneous,Musculocutaneous Flaps,Myocutaneous Flaps

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