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Published on: May 10, 2021
Compartmental tongue surgery for intermediate-advanced squamous cell carcinoma: A multicentric study
Luca Calabrese1, Marta Tagliabue2,3, Alberto Grammatica4
1Department of Otolaryngology-Head and Neck Surgery, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy.
Compartmental tongue surgery (CTS) offers improved survival and reduced recurrence for advanced oral tongue squamous cell carcinoma (OTSCC) compared to standard wide margin surgery (SWMS). This finding holds true regardless of the surgical center, highlighting CTS as a potentially superior oncological approach.
Area of Science:
- Oncology
- Surgical Oncology
- Head and Neck Cancer Research
Background:
- Investigated the technical reproducibility and oncological outcomes of Compartmental Tongue Surgery (CTS) in advanced oral tongue cancers (OTSCC).
- Compared CTS with standard wide margin surgery (SWMS) in a multicentric study.
- Evaluated 551 patients treated with CTS and 50 patients treated with SWMS.
Purpose of the Study:
- To assess the oncological outcomes of Compartmental Tongue Surgery (CTS) for advanced oral tongue cancers (OTSCC).
- To compare the efficacy of CTS against standard wide margin surgery (SWMS).
- To determine if the benefits of CTS are consistent across different surgical centers.
Main Methods:
- Multicentric study involving 551 patients undergoing CTS and 50 patients undergoing SWMS for advanced OTSCC.
- Analysis of oncological outcomes, including survival endpoints.
- Propensity score matching was employed to compare survival data between the two surgical groups.
Main Results:
- In the CTS group, survival was significantly associated with lymph node status, extranodal extension, invasion depth, and T-N tract involvement.
- Compartmental Tongue Surgery (CTS) demonstrated a significantly better Cause-Specific Survival (CSS) (HR 0.11, p=0.03) and Loco-Regional Recurrence Free Survival (LRRFS) (HR 2.54, p<0.001) compared to Standard Wide Margin Surgery (SWMS).
- The positive impact of CTS on survival and recurrence was independent of the performing surgical center.
Conclusions:
- Compartmental Tongue Surgery (CTS) provides superior Cause-Specific Survival (CSS) and Loco-Regional Recurrence Free Survival (LRRFS) compared to Standard Wide Margin Surgery (SWMS) for advanced oral tongue cancers (OTSCC).
- The benefits of CTS are reproducible across different surgical centers, suggesting its technical robustness.
- CTS is recommended as a potentially more effective surgical option for advanced OTSCC.
