Patterns of local recurrence after curative resection and reconstruction for oropharyngeal and oral cancers: Implications for postoperative radiotherapy target volumes

Background We aimed to determine the patterns of local recurrence after curative resection and reconstruction for oropharyngeal and oral cancers. Methods One hundred-fourteen patients with oropharyngeal and oral cancers underwent resection and reconstruction. The local recurrences were classified as intra-flap (the recurrent tumor was located in the flap tissue), marginal (<= 5 mm from the flap anastomosis), and outside (in the original tissue and >5 mm from the anastomosis) recurrences. Results Twenty-seven patients (23.7%) experienced local recurrence, while 32 (28.1%) experienced regional, and nine (7.9%) recurred distantly. Among those who showed local recurrence, one developed outside recurrence and the remaining 26 developed marginal recurrences. Age >60 years and lymph node metastasis were associated with poor disease-free survival and overall survival (OS), while the perineural invasion was related to poor locoregional failure-free survival and OS. Conclusion Most recurrences developed at the anastomosis marginal site, while none developed in the flap tissue.