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Identifying relevant factors of tumor recurrence can help establish treatment standards. Surgery remains the preferred treatment for OSCC. However, for patients at T3-T4 stages and with poorly differentiated tumors, primary tumor resection margin should be expanded, generally 2 cm or more from the tumor, to ensure surgical safety. Flap repair should also be performed. Our results showed that the application of flap repair significantly reduced local tumor recurrence. de Vicente et al.[6] have followed up 98 patients with OSCC. They found that the mortality was 47.0% in patients with flap repair and was 67.3% in patients without flap repair (P < 0.05). Therefore, the application of free flap repair can improve the 5-year survival rate of patients. In addition, neck lymph nodes should be carefully cleaned while resecting the primary tumor. For patients with cN0 diseases, lymph nodes in the ipsilateral neck I-III regions should be selectively cleaned. Capote et al.[7] have performed selective neck lymph node dissection on pT1N0M0 patients and primary tumor resection on patients with pT2N0M0 tumors. They found that the regional recurrence rate was significantly lower in patients who underwent selective neck lymph node dissection than in those who underwent primary tumor resection only. Thus, neck lymph node dissection is an important prognostic factor for the recurrence of OSCC. For neck lymph node-positive patients, radical neck dissection should be performed in the ipsilateral carotid I-V region. Because OSCC might migrate to the IIb region, the sternocleidomastoid should be removed during surgery. Preoperative neoadjuvant chemotherapy and postoperative adjuvant chemotherapy or radiotherapy can also reduce recurrence and improve prognosis. All patients in this study underwent 1-2 cycles of preoperative neoadjuvant chemotherapy, and patients in advanced stages were treated with 4 cycles of adjuvant chemotherapy or radiotherapy after surgery. The recurrence rate was 32.7%, and the 5-year survival rate was 54.5%, both of which were satisfactory. Cooper et al.[8] have also reported that postoperative radiotherapy and chemotherapy can improve disease-free survival and improve local and regional control rate in patients with head and neck squamous cell carcinoma. López Rodríguez et al.[9] have reported that preoperative radiotherapy and chemotherapy for head and neck squamous cell carcinoma at N2-N3 stage can completely control neck lymph node metastasis and achieve local and regional effectiveness.
We pray that peoples of all faiths, all races, all nations, may have their great human needs satisfied; that those now denied opportunity shall come to enjoy it to the full; that all who yearn for freedom may experience its spiritual blessings; that those who have freedom will understand, also, its heavy responsibilities; that all who are insensitive to the needs of others will learn charity; that the scourges of poverty, disease and ignorance will be made to disappear from the earth, and that, in the goodness of time, all peoples will come to live together in a peace guaranteed by the binding force of mutual respect and love.
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