ICHNO-ECHNO 2022 - Abstract Book

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ICHNO-ECHNO 2022

Research Oncological Institute named P. Herzen – the branch of State Organization «National Medical Research Center of Radiology» Ministry of Health of Russia, Department of Microsurgery, Moscow, Russian Federation; 3 Moscow Research Oncological Institute named P. Herzen – the branch of State Organization «National Medical Research Center of Radiology» Ministry of Health of Russia,, Department of Microsurgery, Moscow, Russian Federation Purpose or Objective For reconstruction after subtotal or total glossectomy, both preserving the larynx and maintaining postoperative swallowing and speech functions can greatly improve quality of life; however, postoperative functional results are often unstable. The purpose of this study is to report the outcomes of functional rehabilitation of patients who had undergone total or subtotal glossectomy with mouth floor muscles and suprahyoid muscles resection for oral cancer, reconstructed with a chimeric latissimus dorsi and serratus anterior (LD+SA) free flap with motor innervation. Materials and Methods In the study 20 patients with primary locally advanced tongue cancer and 12 with recurrent cancer from 2016 to 2021 years were included. All patients undergone total or near total glossectomy and subsequent reconstruction with the musculocutaneous chimeric flap LD+SA with motor innervation. Data collection included patient age, sex, performance status, TNM staging, diagnosis and adjuvant treatment. Outcomes were measured pre- and 6,12 months post-surgery and included: swallowing capacity, speech intelligibility, EORTC-H&N 35 quality of life scores and volume reduction in flaps. Results A mean age were 49.6±11.1. Mean follow-up was 15,5 months. In 25 out of 32 patients, a positive functional outcome was recorded, defined as the achievement of an adequate swallowing and speech ability. Modified barium swallow revealed that 25 (78%) patients experienced bolus transit. Speech was restored after 3-6 months after operation. Speech intelligibility was good in 6 (18,8%) patients and acceptable in 17 (56,7%). Successful decannulation was achieved in 6 (18,8%), 15 (46,9%) and 4 (12,5%) patients 1, 3 and 6 months after salvage glossectomy with free flap reconstruction, respectively. Electromyographic recordings showed innervations of the latissimus dorsi muscle with active generation of motor unit potentials in 6 patients when trying to elevate the tongue. Patients who attended >80% of swallowing and speech rehabilitation sessions demonstrated superior swallowing and speech functional outcomes. Conclusion The myocutaneous chimeric LD+SA free flap represents a safe and reliable flap for tongue reconstruction after salvage glossectomy with satisfying functional outcomes and low donor side morbidity. 1 European institute of oncology, Otolaryngology and head and neck surgery, Milan, Italy; 2 European institute of oncology, Experimental oncology, Milan, Italy Purpose or Objective Advanced-stage laryngeal cancer is a challenging disease that needs multimodal treatment. Medical and surgical organ- preservation strategies have been developing in the last decades to spare these functions while granting cancer cure. The aim of this work is to present the single-center outcomes of conservative laryngeal surgery with possible adjuvant treatments. Materials and Methods We collected clinical data of patients submitted to open partial horizontal laryngectomies (OPHLs) and any possible adjuvant treatment from 2005 to 2018. Outcomes were also compared to the most recent studies reporting on both medical and surgical organ-preservation strategies. Results One hundred ten patients were included in the analysis. Adjuvant therapy was employed in 51% of cases. The local control rate was 96.4%, while overall survival (OS) was 67%, and laryngo-esophageal dysfunction free survival (LEDFS) was 66%. Stage IV and vascular invasion were associated with a statistically-significant worse survival. Conclusion OPHLs are valid as upfront treatment in fit patients affected by advanced-stage laryngeal cancer. Disease control and function preservation are granted in a significant percentage of cases, even when followed by adjuvant therapy. PO-0107 Conservative surgery with adjuvant treatment: improved locoregional control in laryngeal cancer M. Tagliabue 1 , F. Chu 1 , S. Zorzi 1 , G. Pietrobon 1 , D.B. Rita 1 , S. Gandini 2 , M. Ansarin 1

PO-0108 Reconstructive surgery with microvascular free flaps after extended resections of nasal tumors

A. Piotrowska-Seweryn 1 , Ł . Krakowczyk 1 , C. Szymczyk 1 , J. Wierzgo ń 1 , R. Szumniak 1 , M. Dobrut 1 , M. Grajek 1 , D. Walczak 1 , G. Hadasik 1 , A. Maciejewski 1 , P. Drozdowski 1 1 National Institute of Oncology Maria Sk ł odowska-Curie National Research Institute, Gliwice Branch, Department of Oncological and Reconstructive Surgery, Gliwice, Poland