Survival rates after surgical salvage procedures using mandible external pin fixation

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Abstract

Aim

The aim of this study was to evaluate if temporary application of a mandible external pin fixator is a helpful tool in salvage surgery of recurrent squamous cell carcinoma (SCC) including segmental mandibulectomy.

Material and methods

Salvage surgery including continuity mandibular resection was performed for treatment of recurrent SCC in 10 patients. The bone defects were bridged using a mandible external fixator. In cases of histologically proven tumour-free margins, secondary reconstruction was performed. In cases of R1-resection, re-resection was performed until R0-resection was achieved. The mandible was reconstructed in a further procedure using regional or distant flaps. Data regarding tumour persistence, re-recurrence, survival rate and complications were analysed retrospectively.

Results

Application of a mandible external pin fixator was possible in all cases. Six patients needed re-resection prior to reconstructive procedures. Reconstruction could be performed in eight patients. Local re-recurrence occurred in one patient. Recurrence within cervical lymph nodes appeared in three patients. The survival rate after a mean follow-up of 42.2 months was 50%.

Conclusions

Temporary external pin fixation of the mandible is a helpful tool for enlarged re-resections. The risk of tumour persistence and early local re-recurrence prior to advanced mandibular reconstruction can be minimised. There is no influence on the survival rate of patients with recurrent SCC of the oral cavity.

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