International Session 18　　Oral Cancer 1

Background : Buccal mucosa and gingivobuccal sulcus cancers are the most common oral cavity malignancies in India, with most patients presenting at advanced stages.microvascular free flaps are the standard reconstructive option, elderly patients with significant comorbidities often cannot tolerate prolonged surgery.In such cases, pedicled flaps like the submental flap(SMF)offers a reliable alternative with shorter operative time and low donor site morbidity.Methods : We retrospectively analyzed 136 patients aged ＞65 years with multiple comorbidities who underwent composite resection with immediate SMF reconstruction between 2018 and January 2024.Postoperative complications, operative time, and oncological outcomes were assessed over a median follow-up of 24 months.Results : Complete flap survival was achieved in 94． 1％ of patients.Mean operative time was 180-210 minutes, with no perioperative mortality.Locoregional recurrence occurred in 19． 1％ of patients and was significantly higher in node-positive disease(p＝0． 008) .Conclusion : The submental flap is a safe, effective, and oncologically sound reconstructive option for elderly and medically compromised patients.