Margin mapping in transoral surgery for head and neck cancer

Hinni, Michael L.; Zarka, Matthew A.; Hoxworth, Joseph M.

doi:10.1002/lary.23900

Cited by 114 publications

(94 citation statements)

References 44 publications

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“…However, transoral resection has been becoming more popular for head and neck cancer, especially for oropharyngeal and laryngeal caner. Hinni et al concluded that piecemeal removal of tumors with three-dimensional margin mapping using an operating microscope or rod telescope is safe from an oncologic standpoint, and reduces morbidity and length of hospital stay [7,8].…”

Section: Discussionmentioning

confidence: 99%

Management for squamous cell carcinoma of the nasal cavity and ethmoid sinus: A single institution experience

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Management for squamous cell carcinoma of the nasal cavity and ethmoid sinus: A single institution experience

et al. 2015

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“…7–12,15 TLM is a technique that can achieve the same in the oral cavity and other sites of the aerodigestive tract with minimal normal tissue disruption. 14,43 …”

Section: Discussionmentioning

confidence: 99%

Histologic and systemic prognosticators for local control and survival in margin‐negative transoral laser microsurgery treated oral cavity squamous cell carcinoma

et al. 2014

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Background Appreciable local recurrence rates observed in patients with margin-negative, transoral laser microsurgery (TLM)-treated oral cavity squamous cell carcinoma (SCC) necessitate identification of new prognosticators for local control and survival. A histopathologic index (Brandwein–Gensler score [BGS]) and intrinsic/iatrogenic/chronic conditions causing immune compromise are investigated. Methods From a prospectively assembled database of TLM-treated oral cavity SCC, specimens for 60 patients with a minimum of 2-years follow-up could undergo BGS assignment. Local control, disease-specific survival (DSS), and overall survival (OS) were study endpoints. Results “Low-BGS” was recorded in 28 patients (47%) and “high-BGS” in 32 patients (53%), whereas immune compromise was observed in 18%. In multivariate analyses, immune compromise was the only predictor for local control. T classification and immune compromise were prognostic for DSS and OS. “High-BGS” was prognostic only for OS. Conclusion “High-BGS” was associated with recurrences but immune compromise was the most significant predictor of local control and survival in margin-negative, TLM-treated oral cavity SCC. Strategies that maintain/restore tumor-specific immune responses in immune compromised oral cavity SCC hosts need to be developed.

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“…Oncologically, Hinni et al [56], in a series of 129 tonsillar region SCC resected transorally, reported ≤ 1 cm resection margins in almost all cases, with a 99% 5-year local control estimate, a 94% recurrence-free survival estimate and a 76% overall survival estimate. In the largest series (111 T1, 132 T2) devoted to non-robotic transoral oropharyngectomy, local recurrence was independent of the site of origin (tonsil, anterior or posterior pillar), with a 89.9% and 85.8% 5-year local control estimate and a 97.2% and 93.2% overall local control estimate after salvage treatment in T1 and T2 SCC, respectively [10].…”

Section: Mandible-sparing Surgery In Early-stage Tonsillar Region Squmentioning

confidence: 96%

“…Over the last 15 years, several teams assessed mandible-sparing surgery in early-stage tonsillar region SCC, and with the introduction of the robotic techniques the transoral approach gained renewed interest [9,10,[50][51][52][53][54][55][56][57][58], the efficacy of which in terms of local control is independent of HPV status, as pointed out by Cohen et al [58].…”

Section: Mandible-sparing Surgery In Early-stage Tonsillar Region Squmentioning

confidence: 99%

The keys to conservative treatment of early-stage squamous cell carcinoma of the tonsillar region

Laccourreye

Castelnau-Marchand²,

Badoual

et al. 2017

European Annals of Otorhinolaryngology, Head and Neck Diseases

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To analyze the medical literature devoted to work-up, epidemiology, local control, survival, complications and sequelae after conservative treatment for early-stage squamous cell carcinoma of the tonsillar region. An analysis of the PubMed (1975-2016) database was performed using the following keywords and associations: "tonsil/tonsillar region/oropharynx" AND "squamous cell carcinoma" AND "early-stage (I-II; T1-2N0M0)" AND "radiation therapy/radiotherapy" OR "conservative surgery/oropharyngectomy/transoral surgery/radical tonsillectomy". The search retrieved 10 retrospective series documenting local control and/or survival in series with more than 50 cases and a minimum 2 years' follow-up after conservative treatment; no prospective studies, meta-analyses and/or Cochrane analyses were found. Magnetic resonance imaging is the key radiological exam for local extension assessment. Human papilloma virus infection (HPV) is a risk factor that must be screened for systematically, since it induces tumoral radio-sensitivity and increases the risk of specific synchronous and metachronous second primaries. Whatever conservative treatment used, local control and survival rates higher than 85% were achieved. Implementing intensity-modulated radiation therapy reduced the incidence and severity of radiation-related complications and sequelae. Transoral surgery yielded very low morbidity/mortality rates, enabled association to ipsilateral neck dissection, and allowed radiation therapy to be reserved for the management of metachronous second primaries. Transoral surgery appeared to be the first-line option in the majority of cases. Lifetime follow-up adapted to HPV status is mandatory. The development of HPV vaccination does not mean that campaigns against smoking and alcohol abuse are of diminished importance.

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Margin mapping in transoral surgery for head and neck cancer

Abstract: 4.

Cited by 114 publications

References 44 publications

Management for squamous cell carcinoma of the nasal cavity and ethmoid sinus: A single institution experience

Management for squamous cell carcinoma of the nasal cavity and ethmoid sinus: A single institution experience

Histologic and systemic prognosticators for local control and survival in margin‐negative transoral laser microsurgery treated oral cavity squamous cell carcinoma

The keys to conservative treatment of early-stage squamous cell carcinoma of the tonsillar region

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