Radical ablative surgery and radial forearm free flap (RFFF) reconstruction for patients with oral or oropharyngeal cancer: postoperative outcomes and oncologic and functional results

Alexandre Bozec MD PhDa*, Gilles Poissonneta, Emmanuel Chamoreyb, Claire Laouta, Jacques Vallicionia, François Demarda, Frédéric Peyradec, Philippe Follanac, René-Jean Bensadound, Karen Benezeryd, Juliette Thariatd, Pierre-Yves Marcye, Anne Sudakaf & Olivier Dassonvilleaa Département de Chirurgieb Département de Statistiques Médicalesc Département d'Oncologie Médicaled Département de Radiothérapiee Département de Radiologief Département d'Anatomo-pathologie, Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, Nice, France† Correspondence: Alexandre Bozec, Département de Chirurgie, Institut Universitaire de la Face et du Cou, Centre Antoine-Lacassagne, 33 avenue de Valombrose, 06189, Nice, France, +33 6 03 49 94 71, +33 4 92 03 15 68 alexandre.bozec@nice.fnclcc.frConclusions. Radical ablative surgery and radial forearm free flap (RFFF) reconstruction provide promising oncologic and functional results in patients with oral or oropharyngeal cancer. Objectives. To assess the postoperative outcomes and the oncologic and functional results, with their main predictive factors, after radical ablative surgery and RFFF reconstruction for patients with oral or oropharyngeal cancer. Patients and methods. Between 2000 and 2006, we prospectively analyzed the postoperative, oncologic and functional outcomes of all previously untreated patients who underwent this type of surgery. Results. A total of 132 patients were enrolled in this study. There were three RFFF failures. The rate of surgical complications was 20%. The 5-year locoregional control and overall survival rates were 68% and 52%, respectively. Advanced age, high comorbidity index, elevated overall stage and tumoral involvement of the inner part of the cheek were correlated with a lower overall survival rate. A good functional result was obtained for oral diet, speech, mouth opening and aesthetic outcome in 87%, 80%, 86% and 88% of the patients, respectively. High comorbidity index, large flap surface, radiotherapy and tumoral involvement of the mobile tongue were significant predictors of poorer functional or aesthetic outcomes.