J Cooke's research while affiliated with The Royal Marsden NHS Foundation Trust and other places

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Publications (1)


The use of computed tomography in assessing oral cancer recurrence after flap reconstruction
  • Article

May 1989

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4 Reads

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10 Citations

American Journal of Otolaryngology

D H Brown

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J Cooke

Following radiation treatment, ablative surgery, and surgical flap reconstruction in cases of oral cancer, postoperative follow-up for oral cancer recurrence presents a difficult task. Computed tomography (CT) remains the most accessible method of postoperative assessment; however, it has yet to be conclusively shown to provide an advantage over an adequate history and physical examination. Twenty-four consecutive patients who had undergone flap reconstruction of the oral cavity for advanced or radiorecurrent disease were studied over an 18-month period. Eight patients showed no evidence of recurrent tumor either clinically or by CT scan. Eleven patients had evidence of recurrent disease clinically, which was confirmed by CT. In four patients, clinically unsuspected regional recurrent tumor was revealed by CT. One false negative scan was encountered. CT proved to be a sensitive modality for detecting clinically unsuspected recurrences, particularly regional recurrences.

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Citations (1)


... 28 The performance of CT is improved over time as postoperative edema and swelling subsides, with follow-up CT at 18 months after flap reconstruction shown to be very sensitive in detecting clinically unsuspected recurrence. 29 Morphologic changes on imaging that are suspicious for recurrence include enlarging and enhancing mass at the primary site or along the surgical flap, enlarging lymph nodes, bone or cartilage erosion, and findings of perineural or perivascular tumor spread. 30,31 Thorough evaluation of the recipient bed, a critical site for local recurrence, is required for nodularity, induration, ulceration or abnormal focal enhancement, especially in the setting of new pain or dysphagia (Figs. 13, 14, and 15). ...

Reference:

Differentiating Post-treatment Changes from Tumor Recurrence in the Oral Cavity and Oropharynx
The use of computed tomography in assessing oral cancer recurrence after flap reconstruction
  • Citing Article
  • May 1989

American Journal of Otolaryngology