评估蒂骨下颌岛状皮瓣（SIF）在病理淋巴结阳性（pN +）颈部的口腔舌鳞状细胞癌（OTSCC）患者中是否可以安全使用，特别是在I级pN +水平。回顾性地，纳入了101例接受SIF重建的OTSCC患者。肿瘤学结局包括局部复发总数、与SIF相关的局部复发（SRLR），其中指瓣部位的局部复发和I级颈部的同侧颈部再发、无复发生存期（RFS）、总生存期（OS）和疾病特异性生存期（DSS）。61例患者为病理淋巴结阴性（pN0），40例为pN +。13例患者出现局部复发，其中5例发生SRLR。 pN +组的局部复发率、5年RFS、OS和DSS均显著高于pN0组（P <0.05）。与pN +不同水平相比，pN0患者的颈部无复发生存期明显更高，无论是在I级水平（P = 0.005）还是在其他水平（P <0.001）。然而，两个pN +亚组的颈部无复发生存期相似（P = 0.550）。特别是，在I级具有pN +的患者与在I级具有pN0的患者相比，SRLR率显著更高（P = 0.006）。多元分析显示，pN +是肿瘤复发和OS的不利因素。由于与具有pN0颈部的SIF相比，SIF在具有I级pN +颈部的OTSCC患者中的SRLR率显著增高，因此我们的数据不支持在I级pN +颈部的OTSCC患者中使用SIF。未经Elsevier Ltd许可，禁止转载。保留所有权利。

To evaluate whether the pedicle submental island flap (SIF) can be safely used in the oral tongue squamous cell carcinoma (OTSCC) patients with pathologically node-positive (pN+) neck, especially pN+ at level I.Retrospectively, 101 OTSCC patients with SIF reconstruction were enrolled. Oncological outcomes included the total locoregional recurrence, the SIF related locoregional recurrence (SRLR) which referred to the local recurrence at flap and ipsilateral neck recurrence at level I, recurrence free survival (RFS), overall survival (OS), and disease specific survival (DSS).Sixty-one patients were pathologically node-negative (pN0) and 40 were pN+. Thirteen patients experienced locoregional recurrence, of which 5 had a SRLR. The pN+ group had a significantly higher locoregional recurrence rate, lower 5-year RFS, OS and DSS than pN0 group (P < 0.05). Patients with pN0 had a significantly higher neck RFS when compared to those with pN+ either at level I (P = 0.005) or at other levels (P < 0.001). However, the neck RFS was similar between the two subgroups of pN+ (P = 0.550). Especially, patients with pN+ at level I had a significantly higher SRLR rate (P = 0.006) compared to those with pN0 at level I. Multivariate analysis showed that pN+ was an unfavorable factor for tumor recurrence and OS.Our data did not support the use of SIF in OTSCC patients with pN+ neck at level I due to an significantly increased SRLR rate compared to those with pN0 neck at level I.Copyright © 2023 Elsevier Ltd. All rights reserved.