Early tongue carcinomas (clinical stage I and II): echo-guided three-dimensional diode laser mini-invasive surgery with evaluation of histological prognostic parameters. A study of 85 cases with prolonged follow-up.
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| Title: | Early tongue carcinomas (clinical stage I and II): echo-guided three-dimensional diode laser mini-invasive surgery with evaluation of histological prognostic parameters. A study of 85 cases with prolonged follow-up. |
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| Authors: | Limongelli, Luisa1, Capodiferro, Saverio1 capodiferro.saverio@gmail.com, Tempesta, Angela1, Sportelli, Pasquale1, Dell'Olio, Fabio1, Angelelli, Giuseppe1, Maiorano, Eugenio2, Favia, Gianfranco1 |
| Source: | Lasers in Medical Science. Apr2020, Vol. 35 Issue 3, p751-758. 8p. |
| Subjects: | Squamous cell carcinoma, Cancer invasiveness, Metastasis, Semiconductor lasers, Cancer prognosis, Patient compliance, Laser therapy, Research, Tongue tumors, Medical lasers, Endoscopic surgery, Research methodology, Prognosis, Evaluation research, Medical cooperation, Tumor classification, Comparative studies, Longitudinal method |
| Abstract: | The management of patients with early stage (cT1-T2) tongue squamous cell carcinoma without clinicoradiologic evidence of neck node metastasis (cN0) has been widely debated over the last 3 decades and still remains controversial. Nevertheless, the identification of patients with low-stage tumours at high-risk for occult cervical metastases is imperative before planning treatments of primary tumours, as well as that of prognostic markers which may possibly select those patients who may benefit of additional workup after surgery in view of the high metastatic potential of the primary tumour. The pre-surgical evaluation of tongue malignant primary tumour (for assessing lateral and deep margins) along with diode laser surgery (with accurate incision, bleeding-free and with reduced/absent post-surgical complications) may lead to a more conservative but equally decisive surgical treatment, also with a greater patient compliance. We studied 85 consecutive cases of cT1-T2 N0 tongue squamous cell carcinoma who had been managed by the following diagnostic/therapeutic protocol: pre-operative high definition ultrasound examination for the evaluation of size and depth, followed by three-dimensional surgical excision by diode laser (wavelength of 800 ± 10 nm, output power of 8 W in continuous wave, flexible optic fibre of 320 μm in contact mode) and detailed histological analyses of well-established prognostic parameters (tumour grade, thickness, depth, front of infiltration and surgical margins) with statistical analysis. No post-surgical photobiomodulation was performed. Overall, 58.82% of patients were stage I, 18% stage II, and the most frequent histotype was squamous cell carcinoma (97.64%). Large nests invasion pattern was observed in 64 cases, expansive pattern in 9, invasion in single cells in 12; front of invasion involved the muscle in 62 cases, vessels in 6, nerves in 15; peritumoural vascular invasion was assessed in 6 patients and perineural invasion in 15. Selective neck lymphadenectomy was performed in 9 cases, and clinically occult node metastases were detected in two cases. At follow-up, 78 patients (98.73%) were alive and free of disease, one patient experienced tumour-related death, while the remaining 6 died for non-disease-related causes. All the histological prognostic parameters were statistically significant (χ2 test; p = 0.05), thus leading to a prognostic weight classification with a three-tiered stratification. On the bases of these results, the authors maintain that the reported diagnostic/therapeutic protocol, including the pre-operative echo-guided three-dimensional evaluation, the following diode laser mini-invasive surgery for tumour excision and the histological examination along with the proposed three-tiered stratification of histological prognostic parameters may allow proper management of clinical stage I and II early tongue carcinomas. [ABSTRACT FROM AUTHOR] |
| Copyright of Lasers in Medical Science is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
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| Items | – Name: Title Label: Title Group: Ti Data: Early tongue carcinomas (clinical stage I and II): echo-guided three-dimensional diode laser mini-invasive surgery with evaluation of histological prognostic parameters. A study of 85 cases with prolonged follow-up. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Limongelli%2C+Luisa%22">Limongelli, Luisa</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Capodiferro%2C+Saverio%22">Capodiferro, Saverio</searchLink><relatesTo>1</relatesTo><i> capodiferro.saverio@gmail.com</i><br /><searchLink fieldCode="AR" term="%22Tempesta%2C+Angela%22">Tempesta, Angela</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Sportelli%2C+Pasquale%22">Sportelli, Pasquale</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Dell'Olio%2C+Fabio%22">Dell'Olio, Fabio</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Angelelli%2C+Giuseppe%22">Angelelli, Giuseppe</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Maiorano%2C+Eugenio%22">Maiorano, Eugenio</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Favia%2C+Gianfranco%22">Favia, Gianfranco</searchLink><relatesTo>1</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Lasers+in+Medical+Science%22">Lasers in Medical Science</searchLink>. Apr2020, Vol. 35 Issue 3, p751-758. 8p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Squamous+cell+carcinoma%22">Squamous cell carcinoma</searchLink><br /><searchLink fieldCode="DE" term="%22Cancer+invasiveness%22">Cancer invasiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Metastasis%22">Metastasis</searchLink><br /><searchLink fieldCode="DE" term="%22Semiconductor+lasers%22">Semiconductor lasers</searchLink><br /><searchLink fieldCode="DE" term="%22Cancer+prognosis%22">Cancer prognosis</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+compliance%22">Patient compliance</searchLink><br /><searchLink fieldCode="DE" term="%22Laser+therapy%22">Laser therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Research%22">Research</searchLink><br /><searchLink fieldCode="DE" term="%22Tongue+tumors%22">Tongue tumors</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+lasers%22">Medical lasers</searchLink><br /><searchLink fieldCode="DE" term="%22Endoscopic+surgery%22">Endoscopic surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Prognosis%22">Prognosis</searchLink><br /><searchLink fieldCode="DE" term="%22Evaluation+research%22">Evaluation research</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+cooperation%22">Medical cooperation</searchLink><br /><searchLink fieldCode="DE" term="%22Tumor+classification%22">Tumor classification</searchLink><br /><searchLink fieldCode="DE" term="%22Comparative+studies%22">Comparative studies</searchLink><br /><searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: The management of patients with early stage (cT1-T2) tongue squamous cell carcinoma without clinicoradiologic evidence of neck node metastasis (cN0) has been widely debated over the last 3 decades and still remains controversial. Nevertheless, the identification of patients with low-stage tumours at high-risk for occult cervical metastases is imperative before planning treatments of primary tumours, as well as that of prognostic markers which may possibly select those patients who may benefit of additional workup after surgery in view of the high metastatic potential of the primary tumour. The pre-surgical evaluation of tongue malignant primary tumour (for assessing lateral and deep margins) along with diode laser surgery (with accurate incision, bleeding-free and with reduced/absent post-surgical complications) may lead to a more conservative but equally decisive surgical treatment, also with a greater patient compliance. We studied 85 consecutive cases of cT1-T2 N0 tongue squamous cell carcinoma who had been managed by the following diagnostic/therapeutic protocol: pre-operative high definition ultrasound examination for the evaluation of size and depth, followed by three-dimensional surgical excision by diode laser (wavelength of 800 ± 10 nm, output power of 8 W in continuous wave, flexible optic fibre of 320 μm in contact mode) and detailed histological analyses of well-established prognostic parameters (tumour grade, thickness, depth, front of infiltration and surgical margins) with statistical analysis. No post-surgical photobiomodulation was performed. Overall, 58.82% of patients were stage I, 18% stage II, and the most frequent histotype was squamous cell carcinoma (97.64%). Large nests invasion pattern was observed in 64 cases, expansive pattern in 9, invasion in single cells in 12; front of invasion involved the muscle in 62 cases, vessels in 6, nerves in 15; peritumoural vascular invasion was assessed in 6 patients and perineural invasion in 15. Selective neck lymphadenectomy was performed in 9 cases, and clinically occult node metastases were detected in two cases. At follow-up, 78 patients (98.73%) were alive and free of disease, one patient experienced tumour-related death, while the remaining 6 died for non-disease-related causes. All the histological prognostic parameters were statistically significant (χ2 test; p = 0.05), thus leading to a prognostic weight classification with a three-tiered stratification. On the bases of these results, the authors maintain that the reported diagnostic/therapeutic protocol, including the pre-operative echo-guided three-dimensional evaluation, the following diode laser mini-invasive surgery for tumour excision and the histological examination along with the proposed three-tiered stratification of histological prognostic parameters may allow proper management of clinical stage I and II early tongue carcinomas. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Lasers in Medical Science is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s10103-019-02932-z Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 8 StartPage: 751 Subjects: – SubjectFull: Squamous cell carcinoma Type: general – SubjectFull: Cancer invasiveness Type: general – SubjectFull: Metastasis Type: general – SubjectFull: Semiconductor lasers Type: general – SubjectFull: Cancer prognosis Type: general – SubjectFull: Patient compliance Type: general – SubjectFull: Laser therapy Type: general – SubjectFull: Research Type: general – SubjectFull: Tongue tumors Type: general – SubjectFull: Medical lasers Type: general – SubjectFull: Endoscopic surgery Type: general – SubjectFull: Research methodology Type: general – SubjectFull: Prognosis Type: general – SubjectFull: Evaluation research Type: general – SubjectFull: Medical cooperation Type: general – SubjectFull: Tumor classification Type: general – SubjectFull: Comparative studies Type: general – SubjectFull: Longitudinal method Type: general Titles: – TitleFull: Early tongue carcinomas (clinical stage I and II): echo-guided three-dimensional diode laser mini-invasive surgery with evaluation of histological prognostic parameters. A study of 85 cases with prolonged follow-up. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Limongelli, Luisa – PersonEntity: Name: NameFull: Capodiferro, Saverio – PersonEntity: Name: NameFull: Tempesta, Angela – PersonEntity: Name: NameFull: Sportelli, Pasquale – PersonEntity: Name: NameFull: Dell'Olio, Fabio – PersonEntity: Name: NameFull: Angelelli, Giuseppe – PersonEntity: Name: NameFull: Maiorano, Eugenio – PersonEntity: Name: NameFull: Favia, Gianfranco IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 04 Text: Apr2020 Type: published Y: 2020 Identifiers: – Type: issn-print Value: 02688921 Numbering: – Type: volume Value: 35 – Type: issue Value: 3 Titles: – TitleFull: Lasers in Medical Science Type: main |
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