72285 - Trends in Head and neck reconstructions over three decades, a snapshot of the Örebro head and neck cancer registry (ÖHNCR)

Introduction In Sweden, approximately 1700 patients are diagnosed with head and neck cancer (HNC) every year. HNC is relatively rare (2,6 % of all cancers). Risk factors for HNC are smoking, high consumption of alcohol, human papilloma virus (HPV) infection and inflammation 1. The Örebro head and neck cancer registry (ÖHNCR) was founded 1988 to register amount of HNC patients, treatment, reconstruction and overall survival. Method We performed a retrospective review of all microvascular and local/regional reconstructions in ÖHNCR from 1988 to 2023. It includes in total 4111 patients in the registry to present day. Result The majority, approximately 71.8% of the patients, were judged to be tumour-free at the last check-up. The five-year survival rate for all HNC patients has increased from 49.8% in 1988 to 55.1% in 2023, an increase of 5.3%. Overall survival varies between types of cancer within HNC. The number of both free and local/regional flaps has increased over the past two decades. Of all reported patients in ÖHHCR, approximately 44 patients (34%) have been reconstructed each year. The most common free flap for soft tissue reconstruction were, radial free flap (n=331, 49%) and osteocutaneous reconstruction was the fibula free flap (n=210, 31%). The most common local/regional flap were pectoralis major flap (n=242, 33%). Discussion The registry data trends correspond with the current literature, with increased incidence of number of cases with HNC and following reconstruction. We speculate that the increased number of reconstructions, permits an increased number of radical HNC resections followed by improved oncological- and functional outcomes.