Head & neck
May 17, 2026 · via Europe PMC
Submental Island Flap Versus Free Flap Reconstruction in Oral Squamous Cell Carcinoma After Neoadjuvant Immunochemotherapy: A Propensity Score Matched Analysis.
Chen D, Zhang H, Dai L, Zhang X, Du W, Yuan J, Fang Q.
AI summary — for doctors, generated from the abstract only
After neoadjuvant immunochemotherapy for oral cancer, submental island flap reconstruction had similar oncologic outcomes to free flap and better recovery and quality of life.
What was studied
Propensity-matched retrospective comparison of 54 submental island flap and 54 free flap patients (from 212 consecutive patients) on survival, operative time, complications and EORTC quality of life.
Key findings
- Operative time and hospital stay were significantly shorter for the island flap (4.5 vs 6.3 h)
- No significant differences in DFS (HR 0.90) or OS (HR 0.83); median follow-up 38.5 months
- Quality of life recovery was superior with the island flap, for example global QoL 81.5 vs 73.9
Clinical relevance
Suggests a less extensive pedicled flap may be adequate in selected patients after neoadjuvant therapy.
Who should care
Limitations
Retrospective and single-source with selection bias possible despite matching; some p-values are cut off in the abstract and the survival CIs are wide.
Comparable cancer outcomes with faster recovery, from observational data only.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
The optimal reconstructive approach following neoadjuvant immunochemotherapy (NICT) and surgery for locally advanced oral squamous cell carcinoma (OSCC) remains debated. This study compared pedicled submental island flap (SIF) and free flap (FF) reconstruction in this contemporary treatment setting.
Methods
We conducted a retrospective comparative study of 212 consecutive patients with locally advanced OSCC treated with NICT followed by surgery. Propensity score matching (1:1) yielded a balanced cohort of 54 SIF and 54 FF patients. Outcomes included disease-free survival (DFS), overall survival (OS), operative time, complications, recovery milestones, and patient-reported quality of life (QoL) assessed via EORTC QLQ-C30/H&N35 at baseline, 3, 6, and 12 months.
Results
Operative time and hospital stay were significantly shorter for SIF (4.5 ± 1.1 vs. 6.3 ± 1.4 h, p 0.05). Median follow-up was 38.5 months. No significant differences were observed in DFS (HR = 0.90, 95% CI: 0.41-1.98, p = 0.796) or OS (HR = 0.83, 95% CI: 0.34-2.00, p = 0.678). However, QoL recovery was superior in the SIF group, with significantly greater improvements in Global QoL (81.5 ± 8.2 vs. 73.9 ± 10.1, p < 0.001), physical and social functioning, and head and neck-specific symptoms (swallowing, speech) at 12 months. Linear mixed models confirmed a favorable SIF trajectory over time (time-by-group interaction p < 0.001).
Conclusion
In patients with locally advanced OSCC undergoing NICT, SIF reconstruction offers comparable oncologic safety to FF while facilitating faster surgical recovery and yielding superior long-term functional and quality of life outcomes.
DOI
10.1002/hed.70322
PMID
42144842
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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