Free Flap Fat Volume is Not Associated With Recurrence or Wound Complications in Oral Cancer

Abstract Objective Adipose stem cells (ASCs) have been shown in many preclinical studies to be potent suppressors of the immune system. Prior studies suggest that ASCs may promote cancer progression and wound healing. However, clinical studies investigating the effects of native, or fat‐grafted adip...

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Main Authors: Andre J. Burnham, Jaime Wicks, Kristen L. Baugnon, Mark W. El‐Deiry, Nicole C. Schmitt
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:OTO Open
Subjects:
Online Access:https://doi.org/10.1002/oto2.46
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author Andre J. Burnham
Jaime Wicks
Kristen L. Baugnon
Mark W. El‐Deiry
Nicole C. Schmitt
author_facet Andre J. Burnham
Jaime Wicks
Kristen L. Baugnon
Mark W. El‐Deiry
Nicole C. Schmitt
author_sort Andre J. Burnham
collection DOAJ
description Abstract Objective Adipose stem cells (ASCs) have been shown in many preclinical studies to be potent suppressors of the immune system. Prior studies suggest that ASCs may promote cancer progression and wound healing. However, clinical studies investigating the effects of native, or fat‐grafted adipose tissue on cancer recurrence have generated mixed results. We investigated whether adipose content in reconstructive free flaps for oral squamous cell carcinoma (OSCC) is associated with disease recurrence and/or reduction in wound complications. Study Design Retrospective chart review. Setting Academic medical center. Methods We performed a review of 55 patients undergoing free flap reconstruction for OSCC over a 14‐month period. Using texture analysis software, we measured the relative free flap fat volume (FFFV) in postoperative computed tomography scans and compared fat volume with patient survival, recurrence, and wound healing complications. Results We report no difference in mean FFFV between patients with or without recurrence: 13.47 cm3 in cancer‐free survivors and 17.99 cm3 in cases that recurred (p = .56). Two‐year recurrence‐free survival in patients with high and low FFFV was 61.0% and 59.1%, respectively (p = .917). Although only 9 patients had wound healing complications, we found no trend in the incidence of wound healing complications between patients with high versus low FFFV. Conclusion FFFV is not associated with recurrence or wound healing in patients undergoing free flap reconstruction for OSCC, suggesting adipose content should not be of concern to the reconstructive surgeon.
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spelling doaj.art-d597116fb94e4160a16e85554cc4b8422023-11-21T15:50:29ZengWileyOTO Open2473-974X2023-01-0171n/an/a10.1002/oto2.46Free Flap Fat Volume is Not Associated With Recurrence or Wound Complications in Oral CancerAndre J. Burnham0Jaime Wicks1Kristen L. Baugnon2Mark W. El‐Deiry3Nicole C. Schmitt4Department of Otolaryngology–Head and Neck Surgery Emory University School of Medicine Atlanta Georgia USADepartment of Radiology Emory University School of Medicine Atlanta Georgia USADepartment of Radiology Emory University School of Medicine Atlanta Georgia USAHead and Neck Program Winship Cancer Institute at Emory University Georgia Atlanta USAHead and Neck Program Winship Cancer Institute at Emory University Georgia Atlanta USAAbstract Objective Adipose stem cells (ASCs) have been shown in many preclinical studies to be potent suppressors of the immune system. Prior studies suggest that ASCs may promote cancer progression and wound healing. However, clinical studies investigating the effects of native, or fat‐grafted adipose tissue on cancer recurrence have generated mixed results. We investigated whether adipose content in reconstructive free flaps for oral squamous cell carcinoma (OSCC) is associated with disease recurrence and/or reduction in wound complications. Study Design Retrospective chart review. Setting Academic medical center. Methods We performed a review of 55 patients undergoing free flap reconstruction for OSCC over a 14‐month period. Using texture analysis software, we measured the relative free flap fat volume (FFFV) in postoperative computed tomography scans and compared fat volume with patient survival, recurrence, and wound healing complications. Results We report no difference in mean FFFV between patients with or without recurrence: 13.47 cm3 in cancer‐free survivors and 17.99 cm3 in cases that recurred (p = .56). Two‐year recurrence‐free survival in patients with high and low FFFV was 61.0% and 59.1%, respectively (p = .917). Although only 9 patients had wound healing complications, we found no trend in the incidence of wound healing complications between patients with high versus low FFFV. Conclusion FFFV is not associated with recurrence or wound healing in patients undergoing free flap reconstruction for OSCC, suggesting adipose content should not be of concern to the reconstructive surgeon.https://doi.org/10.1002/oto2.46adipose stem cellsadipose tissuefree flaphead and neck cancerrecurrence
spellingShingle Andre J. Burnham
Jaime Wicks
Kristen L. Baugnon
Mark W. El‐Deiry
Nicole C. Schmitt
Free Flap Fat Volume is Not Associated With Recurrence or Wound Complications in Oral Cancer
OTO Open
adipose stem cells
adipose tissue
free flap
head and neck cancer
recurrence
title Free Flap Fat Volume is Not Associated With Recurrence or Wound Complications in Oral Cancer
title_full Free Flap Fat Volume is Not Associated With Recurrence or Wound Complications in Oral Cancer
title_fullStr Free Flap Fat Volume is Not Associated With Recurrence or Wound Complications in Oral Cancer
title_full_unstemmed Free Flap Fat Volume is Not Associated With Recurrence or Wound Complications in Oral Cancer
title_short Free Flap Fat Volume is Not Associated With Recurrence or Wound Complications in Oral Cancer
title_sort free flap fat volume is not associated with recurrence or wound complications in oral cancer
topic adipose stem cells
adipose tissue
free flap
head and neck cancer
recurrence
url https://doi.org/10.1002/oto2.46
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