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Total glossectomy in the organ preservation era
José G Vartanian1, José Magrin, Luiz P Kowalski
1Head and Neck Surgery and Otorhinolaryngology Department, A.C. Camargo Hospital, Sao Paulo, Brazil.
Current Opinion in Otolaryngology & Head and Neck Surgery
|March 18, 2010
Summary
Major glossectomies, including total or subtotal glossectomy, can achieve acceptable oncological and functional outcomes in carefully selected patients with advanced oral or tongue base cancers. This procedure may be used as a primary treatment or after failed chemoradiation.
Area of Science:
- Head and Neck Surgery
- Surgical Oncology
- Oral Cancer Treatment
Background:
- Total or subtotal glossectomy is a high-morbidity procedure.
- Chemoradiation for advanced oral and oropharyngeal cancers also carries significant morbidity.
- There is a need to compare long-term outcomes between chemoradiation and major glossectomies.
Purpose of the Study:
- To review the oncological and functional outcomes of total or subtotal glossectomy.
- To evaluate glossectomy as a primary or salvage procedure for advanced oral and tongue base carcinomas.
- To assess the role of glossectomy in institutions with specific protocols or after failed chemoradiation.
Main Methods:
- Review of existing literature on glossectomy and chemoradiation for advanced oral cancers.
- Analysis of oncological and functional outcomes reported in selected cases.
- Comparison of outcomes between glossectomy and chemoradiation where data is available.
Main Results:
- Major glossectomies can yield acceptable oncological and functional results in highly selected patients.
- Chemoradiation for advanced cancers is also highly morbid, with some studies reporting reasonable functional results after glossectomy.
- Prospective trials comparing long-term outcomes between chemoradiation and major glossectomies are lacking.
Conclusions:
- Total and/or subtotal glossectomies with immediate reconstruction are feasible in highly selected patients.
- These procedures can be performed as primary or salvage treatments for advanced oral or base of tongue carcinomas.
- Acceptable oncological and functional outcomes can be achieved with careful patient selection and surgical technique.
