Oncologic safety of autologous fat grafting in head and neck cancer patients: A scoping review

TL;DR

This review examines whether using a patient's own fat for reconstructive surgery is safe for head and neck cancer patients, finding no evidence of increased cancer recurrence.

Contribution

The study provides a scoping review of oncologic safety of autologous fat grafting in head and neck cancer patients.

Findings

No evidence of increased tumor recurrence or metastasis was found in the reviewed studies.

AFG showed favorable functional and aesthetic outcomes in head and neck cancer patients.

Methodological variability and short follow-up durations limit the strength of current conclusions.

Abstract

Autologous fat grafting (AFG) has become increasingly used in reconstructive surgery due to its accessibility, safety, and regenerative potential. In head and neck cancer (HNC) patients, however, concerns remain regarding its oncologic safety, particularly due to the presence of adipose-derived stem cells (ASCs), which may theoretically influence tumor recurrence. This scoping review aims to synthesize current evidence regarding the safety of AFG in this unique patient population.

The review was conducted following the PRISMA-ScR guidelines. PubMed and Scopus databases were searched up to December 2024 using the terms "autologous fat grafting," "lipofilling," "head and neck cancer," and "oncologic safety." Eligible studies included clinical or experimental works reporting on AFG in HNC patients with oncologic outcome assessment. Exclusion criteria included purely aesthetic procedures and studies without relevance to oncologic safety. Data were extracted on study design, patient population, fat grafting technique, follow-up, and reported oncologic outcomes.

Five key studies fulfilled the inclusion criteria. Across these works, no evidence of increased recurrence or metastasis following AFG was reported. Favorable functional and aesthetic outcomes were consistently observed, although methodological variability and short follow-up durations limited the robustness of conclusions.

Current evidence suggests that AFG is oncologically safe and beneficial for reconstructive purposes in head and neck cancer patients, improving contour and tissue quality. Nevertheless, the lack of large, prospective, and long-term studies precludes definitive recommendations. Standardized protocols and extended oncologic follow-up are essential to confirm safety and guide future clinical practice.