Comparison of different guidelines for oral cancer

Köhler, Hugo Fontan; Mehanna, Hisham; Shah, Jatin P.; Sanábria, Álvaro; Fagan, Johannes J.; Kuriakose, Moni Abraham; Leemans, C. René; O’Sullivan, Brian; Krishnan, Suren; Kowalski, Luiz Paulo

doi:10.1007/s00405-020-06423-8

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…Although, the overall treatment involves an interdisciplinary team, according to global guidelines surgery is thegold standard for the initial treatment of OC (including tongue cancer). This involves diagnosis by biopsy, followed by usually surgical therapy with resection of the cancer and selective neck dissection to remove the entire tumor and any metastases in the lymph nodes to improve patient outcomes [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Apart from the requirement of biopsy for diagnosis, one of the primary goals of surgical treatment is surgical resection with adequate resection margins [ 14 , 15 ], with guidelines suggesting at least 10 mm around the palpable margin of the tumor [ 3 , 16 ]. The idea behind this is that individual tumor cells may be localized even in areas that appear unchanged macroscopically [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Development and validation of a cadaveric porcine pseudotumor model for oral cancer biopsy and resection training

Melchior,

Isfort,

Braunschweig

et al. 2024

BMC Med Educ

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Objective The gold standard of oral cancer (OC) treatment is diagnostic confirmation by biopsy followed by surgical treatment. However, studies have shown that dentists have difficulty performing biopsies, dental students lack knowledge about OC, and surgeons do not always maintain a safe margin during tumor resection. To address this, biopsies and resections could be trained under realistic conditions outside the patient. The aim of this study was to develop and to validate a porcine pseudotumor model of the tongue. Methods An interdisciplinary team reflecting various specialties involved in the oncological treatment of head and neck oncology developed a porcine pseudotumor model of the tongue in which biopsies and resections can be practiced. The refined model was validated in a final trial of 10 participants who each resected four pseudotumors on a tongue, resulting in a total of 40 resected pseudotumors. The participants (7 residents and 3 specialists) had an experience in OC treatment ranging from 0.5 to 27 years. Resection margins (minimum and maximum) were assessed macroscopically and compared beside self-assessed margins and resection time between residents and specialists. Furthermore, the model was evaluated using Likert-type questions on haptic and radiological fidelity, its usefulness as a training model, as well as its imageability using CT and ultrasound. Results The model haptically resembles OC (3.0 ± 0.5; 4-point Likert scale), can be visualized with medical imaging and macroscopically evaluated immediately after resection providing feedback. Although, participants (3.2 ± 0.4) tended to agree that they had resected the pseudotumor with an ideal safety margin (10 mm), the mean minimum resection margin was insufficient at 4.2 ± 1.2 mm (mean ± SD), comparable to reported margins in literature. Simultaneously, a maximum resection margin of 18.4 ± 6.1 mm was measured, indicating partial over-resection. Although specialists were faster at resection (p < 0.001), this had no effect on margins (p = 0.114). Overall, the model was well received by the participants, and they could see it being implemented in training (3.7 ± 0.5). Conclusion The model, which is cost-effective, cryopreservable, and provides a risk-free training environment, is ideal for training in OC biopsy and resection and could be incorporated into dental, medical, or oncologic surgery curricula. Future studies should evaluate the long-term training effects using this model and its potential impact on improving patient outcomes.

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Section: Introductionmentioning

confidence: 99%