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

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 cm(3) in cancer‐free survivors and 17.99 cm(3) 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.