Results of using revascularized flaps in patients with oral cancer after neoadjuvant chemotherapy

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Abstract

Introduction. In Russia, cancer of the oral mucosa is diagnosed in more than 9500 patients every year. In 65–70 % of cases, the disease is diagnosed at stages III–IV. Despite the use of combination treatment, prognosis in patients with stage III and IVA oral mucosa cancer remains unfavorable. Neoadjuvant chemotherapy is considered a strategy to decrease the risk of distant metastasis, decrease tumor volume, and affect the status of surgical resection margins.
Aim. To evaluate the results of using revascularized flaps in patients with resectable stage III and IVA cancer of the oral mucosa who received neoadjuvant chemotherapy.
Materials and methods. Retrospective analysis of data of 41 patients who underwent surgery in 2020–2023 at the Republican Clinical Oncological Dispensary (Ufa) was performed. All patients underwent R0 resection with subsequent defect reconstruction using revascularized flaps. Two groups were compared: primary patients (n = 31) and patients who received neoadjuvant therapy per the DCF (docetaxel, cisplatin, 5‑fluorouracil) (n = 10) scheme.
Results. Overall rate of complications in the groups of primary patients and patients receiving neoadjuvant therapy per the DCF scheme was 16.1 and 20 %, respectively (p = 0.398), however the rate of flap loss was significantly higher in patients who underwent neoadjuvant chemotherapy: 40 % versus 9.7 % (p = 0.047). Recurrence rate in the neoadjuvant chemotherapy group was 10 %, in the group without neoadjuvant therapy it was 38.7 % (p = 0.129).
Conclusion. Neoadjuvant chemotherapy can be associated with higher risk of microvascular complications and flap loss but it decreases the recurrence rate. Therefore, further search for the optimal treatment strategy for patients with cancer of the oral mucosa is necessary.

About the authors

Sh. I. Musin

Republican Clinical Oncology Dispensary, Ministry of Health of the Republic of Bashkortostan

Author for correspondence.
Email: Musin_shamil@mail.ru
ORCID iD: 0000-0003-1185-977X

Shamil Ismagilovich Musin

73/1 Prospekt Oktyabrya, Ufa 450054

Russian Federation

K. V. Menshikov

Republican Clinical Oncology Dispensary, Ministry of Health of the Republic of Bashkortostan;
Bashkir State Medical University, Ministry of Health of Russia

Email: fake@neicon.ru
ORCID iD: 0000-0003-3734-2779

73/1 Prospekt Oktyabrya, Ufa 450054;

3 Leninа St., Ufa 450008

Russian Federation

A. V. Sultanbaev

Republican Clinical Oncology Dispensary, Ministry of Health of the Republic of Bashkortostan;
Bashkir State Medical University, Ministry of Health of Russia

Email: fake@neicon.ru
ORCID iD: 0000-0003-0996-5995

73/1 Prospekt Oktyabrya, Ufa 450054;

3 Leninа St., Ufa 450008

Russian Federation

N. A. Sharafutdinov

Republican Clinical Oncology Dispensary, Ministry of Health of the Republic of Bashkortostan

Email: fake@neicon.ru
ORCID iD: 0009-0007-4933-7236

73/1 Prospekt Oktyabrya, Ufa 450054

Russian Federation

M. M. Zamilov

Republican Clinical Oncology Dispensary, Ministry of Health of the Republic of Bashkortostan

Email: fake@neicon.ru
ORCID iD: 0000-0003-0918-3993

73/1 Prospekt Oktyabrya, Ufa 450054

Russian Federation

R. T. Ayupov

Republican Clinical Oncology Dispensary, Ministry of Health of the Republic of Bashkortostan

Email: fake@neicon.ru
ORCID iD: 0000-0002-6769-7194

73/1 Prospekt Oktyabrya, Ufa 450054

Russian Federation

A. F. Nasretdinov

Republican Clinical Oncology Dispensary, Ministry of Health of the Republic of Bashkortostan

Email: fake@neicon.ru
ORCID iD: 0000-0001-8340-7962

73/1 Prospekt Oktyabrya, Ufa 450054

Russian Federation

A. O. Guz

Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine

Email: fake@neicon.ru
ORCID iD: 0000-0002-8164-2261

42 Blukher St., Chelyabinsk 454087

Russian Federation

D. M. Fatkullin

Republican Clinical Oncology Dispensary, Ministry of Health of the Republic of Bashkortostan

Email: fake@neicon.ru
ORCID iD: 0000-0001-9533-4107

450054 Уфа, пр-кт Октября, 73/1

Russian Federation

A. N. Rudyk

Republican Clinical Oncology Dispensary, Ministry of Health of Republic of Tatarstan named after Prof.M. Z. Sigal;
Kazan State Medical Academy – a branch of Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia;
Scientific Research Laboratory “Biomarker”, Institute of Fundamental Medicine and Biology of the Kazan (Volga Region) Federal University

Email: fake@neicon.ru
ORCID iD: 0000-0002-7309-9043

29 Sibirskiy Trakt, Kazan 420029;

36 Butlerova St., Kazan 420012;

Bld. 1, 18 Kremlevskaya St., Kazan 420008

Russian Federation

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