Comparison of long‐term outcomes between pull‐through resection and mandibular lip‐split surgery for T4a tongue/floor of mouth cancers

Background The purpose of this study was to determine whether the pull‐through resection is better than the mandibular lip‐split for advanced tongue/floor of mouth (FOM) cancers, which remains inconclusive. Methods A retrospective cohort study was performed on 91 patients with T4a tongue/FOM cancers...

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Veröffentlicht in:Head & neck 2018-01, Vol.40 (1), p.144-153
Hauptverfasser: Cheng, Shih‐Jung, Ko, Hui‐Hsin, Lee, Jang‐Jaer, Kok, Sang‐Heng
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creator Cheng, Shih‐Jung
Ko, Hui‐Hsin
Lee, Jang‐Jaer
Kok, Sang‐Heng
description Background The purpose of this study was to determine whether the pull‐through resection is better than the mandibular lip‐split for advanced tongue/floor of mouth (FOM) cancers, which remains inconclusive. Methods A retrospective cohort study was performed on 91 patients with T4a tongue/FOM cancers from 2009 to 2014. Cases with mandibular resection were excluded. The pull‐through resection was used when the mouth opening was ≥15 mm; otherwise the mandibular lip‐split was used. Results Fifty‐eight patients received pull‐through resections and 33 underwent mandibular‐lip splits and the mean follow‐up periods were 42 and 45 months, respectively. Surgical margin, locoregional recurrence, and 5‐year survival were similar between the 2 groups. The pull‐through approach had a significantly shorter operation time, lower rates of flap infection, osteoradionecrosis, metal plate exposure, loss of tooth vitality, and better aesthetics. Conclusion Our data suggest that the pull‐through resection does not compromise disease control for advanced tongue/FOM cancers and is superior to the mandibular lip‐split in terms of operation time, postoperative complications, and aesthetics.
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Methods A retrospective cohort study was performed on 91 patients with T4a tongue/FOM cancers from 2009 to 2014. Cases with mandibular resection were excluded. The pull‐through resection was used when the mouth opening was ≥15 mm; otherwise the mandibular lip‐split was used. Results Fifty‐eight patients received pull‐through resections and 33 underwent mandibular‐lip splits and the mean follow‐up periods were 42 and 45 months, respectively. Surgical margin, locoregional recurrence, and 5‐year survival were similar between the 2 groups. The pull‐through approach had a significantly shorter operation time, lower rates of flap infection, osteoradionecrosis, metal plate exposure, loss of tooth vitality, and better aesthetics. Conclusion Our data suggest that the pull‐through resection does not compromise disease control for advanced tongue/FOM cancers and is superior to the mandibular lip‐split in terms of operation time, postoperative complications, and aesthetics.</description><identifier>ISSN: 1043-3074</identifier><identifier>EISSN: 1097-0347</identifier><identifier>DOI: 10.1002/hed.24994</identifier><identifier>PMID: 29140581</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Disease control ; Head and neck ; Lip ; Mandible ; mandibular lip‐split ; Mouth ; Oral cancer ; oral squamous cell carcinoma ; Osteoradionecrosis ; pull‐through ; Surgery ; surgical approach ; Teeth ; Tongue ; tongue/floor of mouth cancers</subject><ispartof>Head &amp; neck, 2018-01, Vol.40 (1), p.144-153</ispartof><rights>2017 Wiley Periodicals, Inc.</rights><rights>2018 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4194-8185c597d1a4783f465f1d63f59990ddf45fa7eb297d9417bfa336b2c11dc1693</citedby><cites>FETCH-LOGICAL-c4194-8185c597d1a4783f465f1d63f59990ddf45fa7eb297d9417bfa336b2c11dc1693</cites><orcidid>0000-0003-4674-4892</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fhed.24994$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fhed.24994$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29140581$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cheng, Shih‐Jung</creatorcontrib><creatorcontrib>Ko, Hui‐Hsin</creatorcontrib><creatorcontrib>Lee, Jang‐Jaer</creatorcontrib><creatorcontrib>Kok, Sang‐Heng</creatorcontrib><title>Comparison of long‐term outcomes between pull‐through resection and mandibular lip‐split surgery for T4a tongue/floor of mouth cancers</title><title>Head &amp; neck</title><addtitle>Head Neck</addtitle><description>Background The purpose of this study was to determine whether the pull‐through resection is better than the mandibular lip‐split for advanced tongue/floor of mouth (FOM) cancers, which remains inconclusive. Methods A retrospective cohort study was performed on 91 patients with T4a tongue/FOM cancers from 2009 to 2014. Cases with mandibular resection were excluded. The pull‐through resection was used when the mouth opening was ≥15 mm; otherwise the mandibular lip‐split was used. Results Fifty‐eight patients received pull‐through resections and 33 underwent mandibular‐lip splits and the mean follow‐up periods were 42 and 45 months, respectively. Surgical margin, locoregional recurrence, and 5‐year survival were similar between the 2 groups. The pull‐through approach had a significantly shorter operation time, lower rates of flap infection, osteoradionecrosis, metal plate exposure, loss of tooth vitality, and better aesthetics. 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subjects Disease control
Head and neck
Lip
Mandible
mandibular lip‐split
Mouth
Oral cancer
oral squamous cell carcinoma
Osteoradionecrosis
pull‐through
Surgery
surgical approach
Teeth
Tongue
tongue/floor of mouth cancers
title Comparison of long‐term outcomes between pull‐through resection and mandibular lip‐split surgery for T4a tongue/floor of mouth cancers
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