The role of transoral surgery in the diagnosis of the carcinoma of unknown origin of the head and neck

Mehanna, Hisham

doi:10.1097/moo.0000000000000880

Cited by 3 publications

(1 citation statement)

References 33 publications

(43 reference statements)

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“…Whether to perform the exam under anesthesia, and the palatine and lingual tonsillectomies concurrently or sequentially, is a matter of debate. 64 Although the concurrent approach may minimize treatment initiation delay, procedure related-complications may lead to prolonged hospital stay and an increase in overall costs. 65 …”

Section: Identification Of Primary Tumor Sitementioning

confidence: 99%

Head and Neck Squamous Cell Carcinoma of Unknown Primary: A Diagnostic Work-Up

Manoharan,

Kalman,

Rabinowits

2023

The Oncologist

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The current work-up of the primary tumor site of a head and neck squamous cell carcinoma of unknown primary is not standardized and results in several time-consuming procedures that delay treatment initiation. This article seeks to consolidate contemporary strategies used to identify the primary tumor site of an unknown primary head and neck squamous cell carcinoma and offer recommendations based on current literature review.

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Section: Identification Of Primary Tumor Sitementioning

confidence: 99%

Head and Neck Squamous Cell Carcinoma of Unknown Primary: A Diagnostic Work-Up

Manoharan,

Kalman,

Rabinowits

2023

The Oncologist

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Surgeon-performed intraoperative transoral ultrasound improves the detection of human papillomavirus-positive head and neck cancers of unknown primary

Garset-Zamani,

Lomholt,

Charabi

et al. 2024

Oral Oncology

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Diagnosis and prognosis of different methods of tongue base mucosectomy for occult head and neck cancer: A systematic review and meta-analysis

Wang,

Zou,

Gao

et al. 2024

Medicine

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Background: Trans-oral robotic surgery (TORS) and trans-oral laser microsurgery (TLM) have been increasingly employed for the diagnosis and identification of primary occult cancers in the head and neck region. This systematic review and meta-analysis aimed to evaluate the application and effectiveness of tonsillectomy with TORS and TLM in detecting these cancers. Methods: We searched PubMed, EMBASE, and the Cochrane Library for eligible studies using TORS or TLM in identifying the unknown primary sites of occult head and neck cancer, published from inception to September 2023. Two investigators independently screened articles based on inclusion and exclusion criteria. Results: From 2282 articles identified, 20 individual studies meeting the inclusion criteria were included in this meta-analysis. Primary tumors were identified by TORS/TLM in 65% (364/561) of patients. The initial identification rates of lingual tonsillectomy (n = 219) and palatine tonsillectomy (n = 83) were 39% and 15%, respectively. The identification rates of primary sites for trans-oral surgical techniques were 60.7% (95% CI, 49.4–72%) for TORS and 75.7% (95% CI, 60.7–90.7%) for TLM. Seventy-nine point six percent (467/587) of the tumors were associated with human papilloma virus (HPV). The detection rate of HPV+ tumors was 79% (173/220) and the detection rate of HPV− tumors was 10% (5/52). The most common complication was nasogastric/gastrostomy, accounting for 6% (29/481). The length of hospital stay reported varied from 1 to more than 7 days. Conclusion: This is a latest systematic review of the detection rates of head and neck squamous cell carcinoma of unknown primary sites by tongue base mucosectomy (TBM) via TORS and TBM via TLM. This study confirmed that TBM via TLM performed better than TBM–TORS in the detection rate of the primary. In particular, TBM via TLM showed significant advantages in detecting primary lesions in HPV-positive head and neck squamous cell carcinoma of unknown primary patients.

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The role of transoral surgery in the diagnosis of the carcinoma of unknown origin of the head and neck

Cited by 3 publications

References 33 publications

Head and Neck Squamous Cell Carcinoma of Unknown Primary: A Diagnostic Work-Up

Head and Neck Squamous Cell Carcinoma of Unknown Primary: A Diagnostic Work-Up

Surgeon-performed intraoperative transoral ultrasound improves the detection of human papillomavirus-positive head and neck cancers of unknown primary

Diagnosis and prognosis of different methods of tongue base mucosectomy for occult head and neck cancer: A systematic review and meta-analysis

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