Risk of lymph node metastases after en bloc cold steel, en bloc laser-, and piecemeal laser surgical resection of auricular VX2 carcinoma

Abstract

There is some controversy in the literature if lymph vessels are enduring sealed during piecemeal CO2 laser surgery of squamous cell carcinomas of the head and neck or a propagation of tumor cells into the lymphatics occurs. The aim of the present study was to analyze the incidence of lymph node and distant metastases after different methods of resection of a VX2 carcinoma in an animal model. A solid auricular VX2 carcinoma was induced in 200 rabbits. Seven days later, an en bloc cold steel (group A), en bloc laser surgical resection with CO2 laser in continuous wave mode with 2 W (group B), or piecemeal laser surgical resection after transection of the tumor with CO2 laser in continuous wave mode with 2 W (group C) or 20 W (group D) was performed. The animals were killed and the incidence of lymph node and distant metastases was compared between the different groups. Of the rabbits, 21.1 % developed lymph node metastases and 10 % pulmonary metastases. The incidence of lymph node metastases was 17.4 % in group A, 20.4 % in group B, 26 % in group C, and 20 % in group D. These differences were not statistically significant. En bloc cold steel, en bloc laser-, or piecemeal laser surgical resections include similar risk of postoperative metastases. Propagation of tumor cells cannot be excluded with certainty by any of these methods.

Rabbit VX2 lung tumor models can form early nodal metastases

“…Xu et al reported that VX2 endometrial cancer models only developed histologically-proven metastases at 21 days [2]. By comparison, there are reports of auricular cancer models developing nodal metastases within 7 days [20]. Local tissue environments, including oxygen tension, vascularity, and tissue compliance, may contribute to these differences.…”

En bloc resection of epiglottic tumors with transoral robotic approach - preliminary results

“…Mechanical trauma to the tumor mass itself or explosion‐like tumor cell spread into the lymphatic network could also precipitate metastases . Another recent experimental study on an animal model failed to find a significant difference between en bloc cold steel, en bloc laser, or piecemeal laser surgical resections for developing postoperative metastases . The possibility of propagation of tumor cells with piecemeal resection remains to be investigated.…”