Survival Analysis of Free Flap Reconstructions in Head and Neck Cancer Patients in Rajavithi Hospital: 10 years’ Experience
DOI:
https://doi.org/10.14456/jdms.2023.24Keywords:
Head and neck cancer, Free flap, Reconstruction, Survival, OutcomeAbstract
Background: Free flap reconstruction in head and neck cancer is a major operation that consumes a largeamount of hospital resources, and most patients present with an advanced stage that results in a poor outcome. Thisstudy aimed to find the survival outcome and compare factors that may contribute to the survival rate. Objective:To assess the 5-year overall survival in head and neck cancer patients treated with free flap reconstruction atOtolaryngology Head-Neck Surgery Department, Rajavithi Hospital, and to study the success rate, complications, andfactors associated with survival rate. Method: All patients diagnosed with head and neck cancer between 2011 and2019 who underwent free flap reconstructions were enrolled. Retrospective charts were reviewed, and data wereextracted by the author. Survival analysis using Kaplan Meier (KM) methods, and differences in survival groups wereassessed with log-rank tests. Multivariable analysis was conducted using Cox-regression. Result: A total of 575 patientswere enrolled, and the 5-year overall survival was 35%, with median survival time was 27 months. T stage, N stageand prognostic factor stage were factors contributed to the survival rate (p < .001), whereas age, smoking, alcohol,tissue pathology, and tumor subsite did not show any statistically significant relations. The multivariable adjustedHR was 1.81 (1.38, 2.93) for N2 compared to N0 patients. Conclusion: Head and neck cancer patients treated withfree flap reconstructions had worse 5-year overall survival, which was associated with higher T, N, and prognosticstage. Age, alcohol consumption, smoking, tumor subsite, and tissue pathology did not show significant associationswith survival in this study.
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