Feasibility and efficacy of radical tumour resection with primary vascularized free flap reconstruction for advanced oral cancer in patients with thrombocytopenia: a prospective study.

Thrombocytopenia is caused by various diseases and increases the risk of bleeding. Radical surgery with vascularized free-flap reconstruction is the preferred approach for advanced oral cancer; however, its safety and feasibility in patients with thrombocytopenia remain unclear. This study aimed to evaluate the safety and feasibility of vascularized free-flap surgery in oral cancer patients with thrombocytopenia. Sixty patients with advanced oral cancer and platelet counts <50×109/L were evaluated and followed for five years. Radical tumour resection, neck lymph node dissection, and vascularized anterolateral thigh (ALT) flap reconstruction were performed under strict perioperative management. Data from 60 patients with advanced oral cancer with normal platelet counts and who underwent similar resections were used as the control group. All ALT flaps survived. The mean preoperative platelet count was 44.15 ± 8.36×109/L. No significant differences were observed in intraoperative blood loss, postoperative drainage volume, wound healing time, and complication rates between groups. The 5-year survival rates were 61.02% and 71.19% in the thrombocytopenia and control groups, respectively. With appropriate perioperative management, patients with thrombocytopenia achieved survival and flap success rates comparable to those with normal platelet counts.