Will the mininvasive approach challenge the old paradigms in oral cancer surgery? View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-08-04

AUTHORS

G. Tirelli, S. Zacchigna, F. Boscolo Nata, E. Quatela, R. Di Lenarda, M. Piovesana

ABSTRACT

In the genome era, the achievement of a safe and complete resection of oral cancers remains a challenge for surgeons. Margin length at histopathological examination is still considered the main indicator of oncological radicality. However, this parameter is fraught by major limitations. Cancer aggressiveness, and in particular its ability to spread in the surrounding tissue, most probably influences loco-regional control and prognosis more than margin length. Unfortunately, no molecular markers are currently available to predict tumor aggressiveness pre-operatively. However, additional histopathological parameters, beside margin length, could be considered to better stratify oral tumors, including depth of invasion (DOI), perineural invasion or composite scores. Recent advances in laser technology have established a novel surgical trend toward a minimalist approach, named transoral laser microsurgery (TLM). TLM provides a local control rate comparable to the one achieved by larger resections if the margin appears disease free, independent from its length. In addition, the clinical availability of innovative optical technologies, such as narrow band imaging (NBI) or autofluorescence, allows more precise and tailored resections, not simply based on clinical observation and ruler measurement. This review will propose the possible implementation of novel procedures toward a mini-invasive surgical approach, providing a satisfactory control rate but significantly improving the quality of life of the patients compared to conventional surgery. More... »

PAGES

1279-1289

References to SciGraph publications

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  • 2013-07-20. Imaging of mandible invasion by oral squamous cell carcinoma using computed tomography, cone-beam computed tomography and bone scintigraphy with SPECT in CLINICAL ORAL INVESTIGATIONS
  • 2012-12-28. Surgical margins in head and neck squamous cell carcinoma: what is ‘close’? in EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY
  • 2010-04-20. Clinicopathological parameters, recurrence, locoregional and distant metastasis in 115 T1-T2 oral squamous cell carcinoma patients in HEAD & NECK ONCOLOGY
  • 2009-10-14. Narrow band imaging and high definition television in the assessment of laryngeal cancer: a prospective study on 279 patients in EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY
  • 1998-09. Surgery versus surgery and postoperative radiotherapy in squamous cell carcinoma of the buccal mucosa: A comparative study in ANNALS OF SURGICAL ONCOLOGY
  • 1983-06. Cervical tissue shrinkage by formaldehyde fixation, paraffin wax embedding, section cutting and mounting in VIRCHOWS ARCHIV A PATHOLOGICAL ANATOMY AND HISTOPATHOLOGY
  • 2007-12-29. Analysis of Risk Factors of Predictive Local Tumor Control in Oral Cavity Cancer in ANNALS OF SURGICAL ONCOLOGY
  • 2012-12-19. Validation of the Risk Model: High-Risk Classification and Tumor Pattern of Invasion Predict Outcome for Patients with Low-Stage Oral Cavity Squamous Cell Carcinoma in HEAD AND NECK PATHOLOGY
  • 2015-07-02. Erratum to: Open questions and novel concepts in oral cancer surgery in EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY
  • 2011-10-11. A gene signature in histologically normal surgical margins is predictive of oral carcinoma recurrence in BMC CANCER
  • 2010-02-13. Contemporary management of cancer of the oral cavity in EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY
  • 2010-01-07. Oral tongue squamous cell carcinoma: recurrent disease is associated with histopathologic risk score and young age in JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
  • 2014-07-29. Diagnostic Modalities for Squamous Cell Carcinoma: An Extensive Review of Literature-Considering Toluidine Blue as a Useful Adjunct in JOURNAL OF MAXILLOFACIAL AND ORAL SURGERY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00405-016-4221-0

    DOI

    http://dx.doi.org/10.1007/s00405-016-4221-0

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/27491319


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