Abstract
IntroductionCancer of the oral cavity and oropharynx presents aggressive behavior and its diagnosis is, in most cases, performed in advanced stages. Total glossectomy is a therapeutic option in locally advanced cancer, and the only one in the recurrent or residual disease, after chemoradiotherapy. ObjectiveTo evaluate the clinical-epidemiological profile, postoperative complications, survival rates and functional aspects of patients with oral cavity and oropharynx cancer after total glossectomy. MethodsIt was a retrospective study where 22 patients were included with oral cavity and oropharyngeal cancer after total glossectomy at the Hospital Regional do Vale do Paraíba, em Taubaté, São Paulo. ResultsAll patients were male, with a median age of 57 years, most of tumors are located in the tongue and floor of the mouth and classified as stage IVa. Total glossectomy as initial treatment was performed in 18 and as salvage in four patients. The major pectoralis myocutaneous flap was used for reconstruction in all cases. The main postoperative complication was wound infection and salivary fistula. ConclusionOverall survival was 19% and cancer-specific survival was 30.8% in five years. Eight patients were rehabilitated for exclusive oral feeding without the dependence tracheostomy and enteral tube, all with an overall survival greater than 15 months.
Highlights
Cancer of the oral cavity and oropharynx has an aggressive behavior and the diagnosis is often attained at advanced stages of the disease
Chemoradiotherapy (CRT) has been used for the treatment of advanced tumors aiming at preserving organs, especially in tumors located in the oropharynx
The main surgical challenges of total glossectomy (TG) are adequate resection of the tumor and reconstruction, aiming to increase the possibilities of cure and to reduce the morbidity related to the functional deficits of the treatment, in order to avoid bronchoaspiration and allow oral feeding without the necessity of using a feeding tube or tracheostomy.[4]
Summary
Cancer of the oral cavity and oropharynx has an aggressive behavior and the diagnosis is often attained at advanced stages of the disease. Total glossectomy (TG) is still a first-line treatment option in extensive tongue cancer, and the only salvage procedure with curative possibilities in patients with residual or recurrent disease, after CRT.[3]. The main surgical challenges of TG are adequate resection of the tumor and reconstruction, aiming to increase the possibilities of cure and to reduce the morbidity related to the functional deficits of the treatment, in order to avoid bronchoaspiration and allow oral feeding without the necessity of using a feeding tube or tracheostomy.[4] In the literature, the definitive feeding tube dependence in the postoperative period in these patients is as high as 30%.4
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