Distant Metastases in Head Neck Cancer: An Impact of Reconstruction Modality
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 2
Abstract
Background: With an estimated yearly global burden of 550,000 incident cases and 300,000 deaths Head neck squamous carcinoma is the sixth most common malignancy reported worldwide, and the eighth most common cause of cancer-related mortality. Surgery is the mainstay of treatment and needs extensive morbid resections. Morbidity is partly compensated with use of microvascular free flaps and provides a more functional outcome. Recurrence after all possible initial treatment is the harbinger of failure and death in head and neck cancers, especially distant metastatic disease which occurs in 4-26% of patient with almost no reported significant 5-year survival. Study: A series of surgically treated head neck cancer patients developing distant metastatic recurrent disease was reviewed to evaluate surgical and etio-pathological factors prognosticating the chance of having recurrence at distal sites with a special focus on the type of reconstruction used.. Results: Along with generally accepted factors like tobacco intake, higher T and N stage, extranodal spread and need for neoadjuvant and adjuvant treatment; use of microvascular free flap reconstruction was more conspicuous and statistically significant in the patients having distant metastatic disease compared to those who had locoregional reconstruction done. Conclusion: Extensive local disease needing multimodality treatment predicts a higher incidence of distant metastatic recurrence. Patients getting a free flap reconstruction also showed a statistically significant chance of the same as compared to those treated with locoregional reconstruction. In the present scenario, where microvascular free flap reconstruction is universally accepted as a safe modality, further studies are needed to confirm its role in occurrence of distal metastases.
Authors and Affiliations
Dr Navin Kasliwa
Keywords
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