Transoral bisected resection for T1-2 oral tongue squamous cell carcinoma to secure adequate deep margin

Choi, Nayeon; Cho, Jae-Keun; Lee, Eun Kyu; Won, Sung Jun; Kim, Bo Young; Baek, Chung‐Hwan

doi:10.1016/j.oraloncology.2017.08.005

Cited by 8 publications

(9 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Table 1 presents the characteristics of the studies ( 20 , 25 – 32 , 43 – 50 ), including one RCT ( 43 ), three prospective cohort studies ( 44 – 46 ), and 13 retrospective studies ( 20 , 25 – 32 , 47 – 50 ). Eight studies were from Asia ( 20 , 30 , 32 , 43 , 44 , 46 , 47 , 50 ), one was Australia ( 45 ), three were from Europe ( 25 , 28 , 29 ), and five were from North America ( 26 , 27 , 31 , 48 , 49 ).…”

Section: Resultsmentioning

confidence: 99%

“…Table 1 presents the characteristics of the studies (20,(25)(26)(27)(28)(29)(30)(31)(32)(43)(44)(45)(46)(47)(48)(49)(50), including one RCT (43), three prospective cohort studies (44)(45)(46), and 13 retrospective studies (20,(25)(26)(27)(28)(29)(30)(31)(32)(47)(48)(49)(50). Eight studies were from Asia (20,30,32,43,44,46,47,50), one was Australia (45), three were from Europe (25,28,29), and five were from North America (26,27,31,48,49). The 17 studies included a total of ...…”

Section: Selection Of the Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic Value of Perineural Invasion in Oral Tongue Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

Liu

et al. 2021

Front. Oncol.

View full text Add to dashboard Cite

ObjectivesA significant number of recently published research has outlined the contribution of perineural invasion (PNI) to clinical outcomes in oral tongue squamous cell carcinoma (OTSCC), but some results remain conflicting. This study aimed to determine whether patients with OTSCC with PNI have a worse prognosis than those without PNI.Materials and MethodsPubMed, Embase, and the Cochrane Library were queried for potentially eligible articles published up to December 2020. The primary outcomes were the hazard ratio (HR) for locoregional recurrence, overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS). The random-effect model was used in all analyses.ResultsSeventeen studies (4445 patients) were included. Using adjusted HRs, the presence of PNI was associated with a higher risk of locoregional recurrence (HR=1.73, 95%CI: 1.07-2.79, P=0.025, I2 = 33.1%, Pheterogeneity=0.224), worse OS (HR=1.94, 95%CI: 1.39-2.72, P<0.001, I2 = 0.0%, Pheterogeneity=0.838), worse DFS (HR=2.13, 95%CI: 1.53-2.96, P<0.001, I2 = 48.4%, Pheterogeneity=0.071), and worse CSS (HR=1.93, 95%CI: 1.40-2.65, P<0.001, I2 = 25.5%, Pheterogeneity=0.251). PNI had an impact on locoregional recurrence in early-stage OTSCC but not in all stages, and on OS, DFS, and CSS in all-stage and early-stage OTSCC. The sensitivity analyses showed that the results were robust.ConclusionThe presence of PNI significantly affects the locoregional recurrence and survival outcomes among patients with OTSCC.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Selection Of the Studiesmentioning

confidence: 99%

Prognostic Value of Perineural Invasion in Oral Tongue Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

Liu

et al. 2021

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…By enhancing mucosal and submucosal vessels and the vascular pattern alterations indicative of malignant transformation (Tirelli, Marcuzzo, & Boscolo Nata, ), intraoperative NBI reduces the rate of positive superficial margins (Tirelli, Marcuzzo, et al, ; Tirelli et al, ; Tirelli, Piovesana, Gatto, Torelli, & Boscolo Nata, ; Tirelli, Piovesana, et al, ). On the other hand, piecemeal resection, introduced to allow laryngeal tumour removal through the small diameter of laryngoscopes (Steiner & Ambrosch, ), has been used in TOS for oropharyngeal (Hinni, Zarka, & Hoxworth, ) and oral cancer (Choi et al, ; Tirelli, Piovesana, et al, ) because it allows one to identify the transition from cancer to healthy tissue thereby improving deep margin control. Despite the help given by these methods, the surgeon needs real‐time information about completeness of the resection, as provided by frozen sections (FS).…”

Section: Introductionmentioning

confidence: 99%

Frozen sections and complete resection in oral cancer surgery

et al. 2019

View full text Add to dashboard Cite

Objectives Although the reliability of frozen sections for the intraoperative assessment of complete tumour excision has been established, the best location for collection and the impact of the type of sampling are still debated. We retrospectively investigated the reliability of frozen sections when collected from the surgical bed as tissue strips representative of the whole superficial margin and as a bowl of tissue underlying the resection site for deep margin, and the possibility of relying on frozen section negativity to consider resections complete. Materials and Methods Frozen section reliability was calculated by comparing histology before and after formalin embedding and then categorised by sampling type, in 182 patients undergoing transoral resection of oral cancer. Results Comparing frozen and permanent histology, sensitivity, specificity and accuracy were 69%, 98% and 96%, respectively; categorisation by sampling type failed to produce statistically significant differences. Based on frozen section negativity after formalin embedding, complete resections were obtained in 91.7% of patients with multiple‐strip and bowl frozen sections. Conclusion Frozen sections collected as tissue strips and bowl are as reliable as point sampling in the intraoperative guidance of surgical resections. They effectively provide for margin enlargement, thereby increasing the surgeon's confidence that negative margins are clear.

show abstract

“…7,9,10 Our results are in agreement with those of the only other study that tried to objectively assess the advantage of piecemeal resection in achieving deep margins control. 42 Differently from Choi et al, 42 who reported a series of T1 to T2 tongue carcinomas, in our study we considered both oral and oropharyngeal cancers and included patients with both early and advanced tumors. Thus, our results further underline the efficacy of piecemeal resection in assessing tumor extension in depth, irrespective of site and stage.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, another significant difference is the tools used to divide and resect the tumor: Choi et al used a monopolar cautery to transect the tumor and harmonic scalpel to perform resection. Conversely in our experience in group 1, the CO2 laser was used both to transect the tumor and resect it.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Margin Control in Transoral Approach for Oral and Oropharyngeal Cancer

et al. 2018

View full text Add to dashboard Cite

Objectives Piecemeal resection provides an innovative conceptual tool for margins surveillance because it entails the intraoperative evaluation of the whole resection margins and not just sample points, which should result in a better control of deep margins compared to en bloc resection. Although it is recognized that the intraoperative use of narrow band imaging (NBI) results in a better control of superficial margins, in this exploratory study we investigated whether NBI and piecemeal resection could be used in combination to improve margin control at both superficial and deep levels. Because piecemeal resection is based on frozen section analysis, we wanted to verify its reliability compared to definitive histological examination. Methods The status of resection margins in a group of patients with oral and oropharyngeal cancers treated with NBI and laser CO2 piecemeal resection (group 1) was compared with that of an historical group of patients (group 2) treated with NBI and conventional en bloc resection. In group 1, sensitivity, specificity, and positive and negative predictive values were used to verify the rate of concordance between frozen section and definitive histology. Results The difference between deep positive margins in the two groups was statistically significant (P = 0.042). The high sensitivity and specificity (94.6% and 94.7%, respectively) of frozen section analysis also demonstrated its reliability in the examination of larger samples corresponding to the whole margin. Conclusion Even if our findings are limited by the small number of patients, we are confident that the combined use of NBI and piecemeal resection could represent an attractive surgical strategy to improve margin control. Level of Evidence 2b Laryngoscope, 129:1810–1815, 2019

show abstract

Transoral bisected resection for T1-2 oral tongue squamous cell carcinoma to secure adequate deep margin

Cited by 8 publications

References 22 publications

Prognostic Value of Perineural Invasion in Oral Tongue Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

Prognostic Value of Perineural Invasion in Oral Tongue Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

Frozen sections and complete resection in oral cancer surgery

Intraoperative Margin Control in Transoral Approach for Oral and Oropharyngeal Cancer

Contact Info

Product

Resources

About