Outcomes and characteristics of head and neck reconstruction in young patients: a retrospective study of 95 cases over 19 years

Purpose: Outcomes of head and neck cancer reconstruction have been reported across age groups. However, data on tumor characteristics and reconstruction patterns in young patients remain limited. This study examined tumor characteristics and flap-related outcomes in young patients with head and neck cancer.Methods: This retrospective study included patients aged ≤40 years who underwent primary flap reconstruction for head and neck cancer between March 2004 and June 2022. Patients who underwent reconstruction for tumor recurrence or osteonecrosis were excluded. Demographic, surgical, and oncologic data were reviewed.Results: Ninety-five patients were included. Tumors most commonly arose in the oral cavity (77 patients), and tongue cancer was the most frequent site (70 patients, 73.7% of all patients). T4 disease was the most common T stage (40 patients, 42.1%), and squamous cell carcinoma was the predominant histological diagnosis (75 patients, 78.9%). Recurrence within 1 year occurred in 15 patients (15.8%). The radial forearm free flap was the most commonly used flap (49.5%). The flap survival rate was 100.0%, the mean hospital stay was 21.45±6.82 days, and the 5-year overall survival rate was 70.0%.Conclusion: Approximately one in six young patients with head and neck cancer experienced recurrence within 1 year. Although T4 disease was relatively common, flap outcomes were favorable. Timely oncologic treatment, including surgical resection, reconstruction, chemotherapy, and radiotherapy, with appropriate surveillance, is important for early detection of recurrence.