Factors affecting carbon dioxide laser treatment for oral precancer: A patient cohort study

Hamadah, Omar; Thomson, Peter

doi:10.1002/lsm.20733

Cited by 50 publications

(40 citation statements)

References 30 publications

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“…We amalgamated the suspicious TIC margins and dysplastic histological margins with the respective positive margins. This made it easier to follow the current management protocol for treatment of oral dysplasia, which is excision [25,26], and enabled us to perform diagnostic validity tests for overall reliability of TIC. Cox et al [24] followed a similar pattern, while Anand et al [27] placed suspicious and dysplastic margins in the negative category.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Imprint Evaluation of Surgical Margins in Oral Squamous Cell Carcinoma

Yadav¹,

Donoghue²,

Tauro³

et al. 2012

Acta Cytologica

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Background: Oral squamous cell carcinoma (OSCC) is a multifactorial malignant epithelial neoplasm. Tumor clearance at the surgical margins in OSCC is a critical factor which strongly influences both the local recurrence and overall survival rate. A quick and accurate intraoperative diagnostic procedure can make a significant difference to the survival rate. Touch imprint cytology (TIC) has commonly been used in the past for the diagnosis of tumors and the detection of sentinel lymph node metastasis. It is routinely applied for intraoperative margin analysis of breast lumpectomy specimens, where it has been proven to have a good success rate. The effectiveness and reliability of TIC in the intraoperative margin evaluation of OSCC, however, has not been established so far. Objective: To investigate the diagnostic accuracy of the intraoperative TIC technique for assessing surgical margins in OSCC in comparison to paraffin-embedded hematoxylin and eosin-stained sections. Materials and Methods: Thirty previously untreated, biopsy-proven OSCC patients undergoing surgical treatment between December 2008 and September 2010 were included. Patients diagnosed with histological variants of squamous cell carcinoma (SCC) or recurrent tumor were excluded. Three hundred forty-eight touch imprint slides were prepared from 174 margins of 30 resected tumor specimens. Imprints from tumor proper were taken as positive controls. The slides were reported as positive, negative or suspicious for tumor. After all cytological interpretation was completed, the results were compared with the corresponding histological diagnosis. Results: This pioneer study showed that TIC has an overall accuracy of 83%, sensitivity of 91.1%, specificity of 74.4%, positive predictive value of 79.2% and a negative predictive value of 88.6%. The false-positive margins evaluated by TIC were 43 (12.3%) and the false-negative ones were 16 (4.6%). Conclusion: TIC is a quick, simple, inexpensive, highly accurate and reliable intraoperative technique to assess surgical margins in SCC of the oral cavity.

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Section: Discussionmentioning

confidence: 99%

Intraoperative Imprint Evaluation of Surgical Margins in Oral Squamous Cell Carcinoma

Yadav¹,

Donoghue²,

Tauro³

et al. 2012

Acta Cytologica

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“…Post-laser therapy recurrences are reported as ranging from 7.7-38.1% and malignant transformations as ranging from 2.6-9% [18]. The most often used lasers for leukoplakia therapy to date have been: the CO2 laser, Nd:YAG laser, and KTP laser [5,7,[18][19][20].…”

Section: Introductionmentioning

confidence: 99%

“…The disadvantage of the laser intervention is partial thermic destruction of the removed lesion, which restricts the histopathological assessment, and delayed epithelial regeneration directly in the wound compared to surgical excision with suture. The use of the laser requires observance of special rules governing the safety of work (such as the necessity to use goggles) [7,18,19]. Until recently, the key restriction for the dissemination of the method was the price of the laser.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of diode laser removal of leukoplakias on the tongue and in lower buccal cavity compared to other buccal cavity locations. A two-year study

Vlk

Smucler

2013

Open Medicine

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AbstractIntroduction. Leukoplakias of the buccal cavity are premalignant lesions with a significant 0–20% potential for malignant transformation. In addition to active follow-up screening procedures, a number of surgical interventions are recommended for their removal. One of the preferred procedures is laser ablation with consecutive histopathology using one of the many types of lasers. The efficacy of such procedure with respect to the lesion location is, however, unclear. Many studies are contradictory. Some shows laser ablations as prevention of malignisation other see it as increased risk. Aim of this is to test treatment in different locations for two years. Material and method. An outpatient ablation by a 980mm diode laser of lesions on the tongue and in the lower buccal cavity (Group A) and lesions in other parts of the buccal cavity (Group B) were performed under local anaesthesia. In total, 76 lesions were treated in 66 patients. Recurrence after 1, 3, 6, 9, 12, and 24 months were followed up. Initially, all lesions were histopathologically tested. Concurrently, the subjective tolerance of the procedure was monitored, using a 1 (ideal) to 5 (worst) scale. Results. Clearing rate of lesions was of 84.6% for Group A and of 94.7% for Group B. In two patients (3% of Group A) malignant transformation occurred which was not observed in Group B. Patient toleration in various time intervals was always higher in Group B, but generally was very high in both groups. Conclusion. Malignant transformation of leukoplakias does occur even after laser ablation, and for this reason it is necessary to subject the patients to systematic follow-ups. It is significantly higher risk of recurrences and malign transformation in tongue and oral base. Laser ablation is a simple and well-tolerated procedure with high clearing rate.

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“…It has a variable incidence and mortality across different countries due to differing risk profiles and availability or access to health services [2,3]. These tumours are often preceded by dysplastic lesions that are characterised histologically by staging from mild to severe dysplasia [4], which may be considered a continuum of tissue disorganization suggesting a progressively increased risk of malignant change [5]. The aetiology of these lesions includes smoking, alcohol consumption, and betel quid chewing [6].…”

Section: Introductionmentioning

confidence: 99%

“…Surgical methods include excision by scalpel, laser, electrocautery/ cryotherapy and photodynamic therapy. Medical treatments include vitamin A (retinoids), antioxidants, bleomycin [14], cyclo-oxygenase [4], and a mouthwash containing attenuated adenovirus [15]. Excision of precancerous lesions has yet to be proven to prevent future malignant changes.…”

Section: Introductionmentioning

confidence: 99%

An Immunohistochemical Analysis of Cell Cycle Markers in Oral Mucosal Dysplastic Lesions Treated by Laser Therapy. A Pilot Study

McNaughtan

Rani

et al. 2011

J. Maxillofac. Oral Surg.

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Introduction Over the past 15 years, dysplastic oral mucosal lesions have been treated by laser ablation with variable success. A recent study have shown that the type of laser utilized may be important for patient outcome, however, it may also be changes at a cellular level that could be an important factor in determining recurrence outcome. The aims of this study were to assess cellular markers related to oral dysplastic lesions treated by two different laser types. Methods and Materials Twenty patients with a histopathological diagnosis of dysplasia treated with laser ablation between the years 1992 and 2003 were assessed. Tissue blocks of the original diagnostic biopsy specimens were stained with specific cell cycle markers (Cyclin-D1 and Ki67) via immunohistochemistry and presence of the marker were analysed by virtual microscopy. Patients were assessed according to grade of dysplasia [(mild vs. moderate vs. severe) and the type of laser used (Potassium Titanyl Phosphate (KTP) vs. Carbon Dioxide (CO 2 )]. Results No significant difference in Cyclin-D1 and Ki67 levels were found between the two groups with different grades of dysplasia, however, decreased Cyclin-D1 was found in those patients treated with KTP laser (P = 0.028). Conclusions The findings of the present study may indicate cell cycle makers such as Cyclin-D1, may be responsible for the behaviour of dysplastic lesions treated with laser therapy, rather than the type of laser itself, which was reported in previous studies.

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Factors affecting carbon dioxide laser treatment for oral precancer: A patient cohort study

Cited by 50 publications

References 30 publications

Intraoperative Imprint Evaluation of Surgical Margins in Oral Squamous Cell Carcinoma

Intraoperative Imprint Evaluation of Surgical Margins in Oral Squamous Cell Carcinoma

The efficacy of diode laser removal of leukoplakias on the tongue and in lower buccal cavity compared to other buccal cavity locations. A two-year study

An Immunohistochemical Analysis of Cell Cycle Markers in Oral Mucosal Dysplastic Lesions Treated by Laser Therapy. A Pilot Study

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