Oncological outcomes of compartmental surgery and wide local excision in oral tongue and floor of the mouth cancer
Copyright © 2022 Elsevier Ltd. All rights reserved..
OBJECTIVES: Oral tongue carcinomas represent more than half of the tumors arising in the oral cavity, a site with a high cancer specific mortality and impact on quality of life. Current guidelines are lacking for a standardized surgical approach of these tumors. The aim of this study is to compare two currently adopted surgical strategies, compartmental surgery (CTS) and wide local excision (WLE), with loco-regional control as the main oncological endpoint.
MATERIALS AND METHODS: An observational retrospective multicentric study was carried out enrolling a cohort of patients affected by oral tongue or floor of the mouth squamous cell carcinoma and surgically treated in 4 international tertiary referral centers. Survival analysis was performed by propensity-score matching approach and multivariable Cox regression analysis.
RESULTS: A cohort of 933 patients was enrolled. CTS was applied in 113 patients (12.1%) and WLE in 820 (87.9%). Analyzing a propensity-score matched cohort (98 CTS vs. 172 WLE) and applying a survival multivariable modeling strategy on the whole cohort, both confirmed that CTS and WLE are comparable and oncologically safe. Parameters such as number of positive lymph nodes, depth of invasion, and lymphovascular invasion still represent the key prognosticators.
CONCLUSION: The main goals for surgical resection of oral cancer remain its three-dimensional circumferential clearance with adequate margins and en-bloc removal of the tumor-lymph node tract, independently of the technique adopted (CTS or WLE). Further prospective studies including quality of life evaluation are needed to better understand if one of these approaches can provide superior functional outcomes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:135 |
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| Enthalten in: |
Oral oncology - 135(2022) vom: 01. Dez., Seite 106210 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Missale, Francesco [VerfasserIn] |
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| Links: |
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| Themen: |
Compartmental surgery |
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| Anmerkungen: |
Date Completed 28.11.2022 Date Revised 08.12.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.oraloncology.2022.106210 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM348209967 |
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| 100 | 1 | |a Missale, Francesco |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Oncological outcomes of compartmental surgery and wide local excision in oral tongue and floor of the mouth cancer |
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| 500 | |a Date Revised 08.12.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Elsevier Ltd. All rights reserved. | ||
| 520 | |a OBJECTIVES: Oral tongue carcinomas represent more than half of the tumors arising in the oral cavity, a site with a high cancer specific mortality and impact on quality of life. Current guidelines are lacking for a standardized surgical approach of these tumors. The aim of this study is to compare two currently adopted surgical strategies, compartmental surgery (CTS) and wide local excision (WLE), with loco-regional control as the main oncological endpoint | ||
| 520 | |a MATERIALS AND METHODS: An observational retrospective multicentric study was carried out enrolling a cohort of patients affected by oral tongue or floor of the mouth squamous cell carcinoma and surgically treated in 4 international tertiary referral centers. Survival analysis was performed by propensity-score matching approach and multivariable Cox regression analysis | ||
| 520 | |a RESULTS: A cohort of 933 patients was enrolled. CTS was applied in 113 patients (12.1%) and WLE in 820 (87.9%). Analyzing a propensity-score matched cohort (98 CTS vs. 172 WLE) and applying a survival multivariable modeling strategy on the whole cohort, both confirmed that CTS and WLE are comparable and oncologically safe. Parameters such as number of positive lymph nodes, depth of invasion, and lymphovascular invasion still represent the key prognosticators | ||
| 520 | |a CONCLUSION: The main goals for surgical resection of oral cancer remain its three-dimensional circumferential clearance with adequate margins and en-bloc removal of the tumor-lymph node tract, independently of the technique adopted (CTS or WLE). Further prospective studies including quality of life evaluation are needed to better understand if one of these approaches can provide superior functional outcomes | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Compartmental surgery | |
| 650 | 4 | |a Oral cancer | |
| 650 | 4 | |a Propensity score matching | |
| 650 | 4 | |a Squamous cell carcinoma | |
| 650 | 4 | |a Tongue cancer | |
| 700 | 1 | |a Marchi, Filippo |e verfasserin |4 aut | |
| 700 | 1 | |a Iandelli, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Subramaniam, Narayana |e verfasserin |4 aut | |
| 700 | 1 | |a Dokhe, Yogesh |e verfasserin |4 aut | |
| 700 | 1 | |a Sampieri, Claudio |e verfasserin |4 aut | |
| 700 | 1 | |a Mattavelli, Davide |e verfasserin |4 aut | |
| 700 | 1 | |a Bresciani, Lorenzo |e verfasserin |4 aut | |
| 700 | 1 | |a Carobbio, Andrea Luigi Camillo |e verfasserin |4 aut | |
| 700 | 1 | |a Grammatica, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Thankappan, Krishnakumar |e verfasserin |4 aut | |
| 700 | 1 | |a Iyer, Subramania |e verfasserin |4 aut | |
| 700 | 1 | |a Fontanella, Walter |e verfasserin |4 aut | |
| 700 | 1 | |a Giannini, Lorenzo |e verfasserin |4 aut | |
| 700 | 1 | |a Peretti, Giorgio |e verfasserin |4 aut | |
| 700 | 1 | |a Parrinello, Giampiero |e verfasserin |4 aut | |
| 700 | 1 | |a Balasubramanian, Deepak |e verfasserin |4 aut | |
| 700 | 1 | |a Piazza, Cesare |e verfasserin |4 aut | |
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