OP106: Comparative study of free flap reconstruction after robot-assisted neck dissection versus conventional neck dissection in oral cavity and oropharyngeal cancer

Abstract

Objectives In previous our research, robot-assisted neck dissection (RAND) via a modified face-lift (MFLA) or retroauricular approach showed clear cosmetic benefit compared to conventional neck dissection (ND). We successfully performed free flap reconstruction after RAND in patients with oral and oropharyngeal cancer. To confirm the validity of these procedures, we retrospectively assessed treatment outcomes of free flap reconstruction after RAND compared to outcomes of patients who received free flap reconstruction after conventional ND. Materials and methods Between July 2011 and July 2012, 33 patients were enrolled in this study. Eleven patients received free flap reconstruction after RAND and 22 patients received free flap reconstruction after conventional ND. Perioperative and operative data were collected and analyzed. Results Margin negativity, an important factor of local control, of RAND and conventional ND groups were 82% and 88%, respectively. However, there was no significant difference in the margin negativity. Based on pathologic information for the primary lesion and neck specimens, 45% of RAND group received adjuvant radiotherapy and 50% of conventional ND group received adjuvant therapy. The RAND group showed no significant difference in the aspect of oral diet, decannulation, and hospitalization compared to the conventional ND group. However, the RAND group showed a better cosmetic outcome compared to the conventional ND group. All patients were extremely satisfied with the invisible postoperative scar. The status of the free flap was viable and functioning in all patients. Conclusion Although long-term follow-up of oncologic safety and functional outcome is required to establish these approaches as valid treatment methods, our study has demonstrated the feasibility of free flap reconstruction and RAND via an MFLA or retroauricular approach with clear cosmetic benefits.