Indications for oropharyngeal biopsy in head and neck squamous cell carcinoma of unknown primary: A systematic review (HNSCCUP)

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2024-05-22 DOI:10.1111/coa.14168

Rachael Thomas, Noemi Kelemen, Emma Molena, Shane Lester

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引用次数: 0

Abstract

Introduction

Patients presenting with head and neck squamous cell carcinoma of unknown primary (HNSCCUP) remain challenging clinical scenarios as large variation exists in practices used to locate the primary.

Objective

The objective of this systematic review is to review of the literature and offer recommendations for oropharyngeal biopsies in HNSCCUP.

Method

Pubmed, Medline and Embase were searched to identify studies from inception to October 2021. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed.

Results

A total of 483 articles were included and screened, 41 studies met the inclusion criteria, including over 3400 patients from the original articles (122 of these patients were reported on in two sequential articles by a single author – table 1) and 4 large metaanalyses including 1852 patients. The primary site identification rate following random biopsies or deep tissue biopsies is less than 5% in most studies. The mean detection rate following ipsilateral tonsillectomy is 34%; two pooled analyses indicate that the mean detection rate following tongue base mucosectomy is 64%, with this figure rising when the tonsils are negative.

Conclusions

High level evidence is lacking, with heterogeneity in the reported studies. Published meta-analyses are based on retrospective data. There is little evidence supporting the practice of random/non-directed oropharyngeal biopsies. Available evidence supports palatine tonsillectomy and tongue base mucosectomy compared to deep tissue biopsies.

查看原文本刊更多论文

原发灶不明的头颈部鳞状细胞癌口咽活检指征：系统综述（HNSCCUP）。

导言：原发灶不明的头颈部鳞状细胞癌（HNSCCUP）患者在临床上仍具有挑战性，因为确定原发灶的方法存在很大差异：本系统综述旨在回顾文献，并就 HNSCCUP 的口咽活检提出建议：对Pubmed、Medline和Embase进行检索，以确定从开始到2021年10月的研究。结果：共纳入 483 篇文章：共纳入并筛选了 483 篇文章，41 项研究符合纳入标准，包括原始文章中的 3400 多名患者（其中 122 名患者由一位作者在两篇连续文章中报告--表 1）和 4 项大型荟萃分析（包括 1852 名患者）。在大多数研究中，随机活检或深层组织活检后的原发部位识别率低于 5%。同侧扁桃体切除术后的平均检出率为 34%；两项汇总分析表明，舌根粘液切除术后的平均检出率为 64%，当扁桃体呈阴性时，这一数字会上升：结论：缺乏高水平的证据，报告的研究存在异质性。已发表的荟萃分析基于回顾性数据。支持随机/非定向口咽活检的证据很少。与深层组织活检相比，现有证据支持腭扁桃体切除术和舌根粘液切除术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.