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Figure 1: Recurrent oral squamous cell carcinoma (OSCC) patient 1. (A) Local recurrence of OSCC in the right side of the tongue; (B) regional
recurrence in right cervical level II; (C) intraoperative hemi-glossectomy; (D) intraoperative view of the resected specimen; (E) classical radical neck
dissection; (F) design of the “Iberic graft” technique for reconstruction of the defect with a radial forearm free flap (RFFF); (G) RFFF harvesting; (H)
intraoral view of the reconstruction, with the RFFF showing arterial bleeding and viability

Actually, salvage surgery is being considered as the best xerostomia, among others. Considering that some
[7]
treatment in recurrent OSCC, especially in those patients authors have found a loco-regional recurrence rate of
in which previous radiotherapy has been administered only 18% for patients at intermediate risk of recurrence
as part of the primary treatment, because of the toxicity [close surgical margins (> 1 mm and < 5 mm) and/or
of re-irradiation [Figure 1]. Re-irradiation in SCC of the positive neck disease without ECS], and that 82% of
aero-digestive tract has been reported to have an overall them may not benefit from adjuvant RT, the clinician
5-year survival rate up to 20%, while chemotherapy is must reconsider the systematic administration of post-
[5]
clearly discouraging. The real fact with many recurrent operative RT in those patients without cervical ECS or
OSCC patients is that RT has already been administered an involved margin (< 1 mm from the margin).
as part of the primary treatment, in most of the cases as an
adjuvant therapy to primary surgery, and re-irradiation with In our experience from a single institution (University
its inherent toxicity is not tolerated by the patient. Hospital Infanta Cristina, Badajoz, Spain) treating
SCC of the oral cavity and oropharynx by surgery in
Besides, the main concern with respect to the use of RT is a population area of one million and five hundred
the increased morbidity, such as risk of osteo-radionecrosis thousand inhabitants (Extremadura, Spain), salvage
and caries, worseness of speech and swallowing, and surgery is the best option for recurrent patients, even in
194 Plast Aesthet Res || Volume 3 || June 24, 2016