Comparative Evaluations of Different Surgical and Non-surgical Treatment Methods for Early Invasive and Micro Invasive Squamous Cell Carcinoma in the Oral and Maxillofacial Regions: A Systematic Review.

Abstract

OBJECTIVES The pathogenesis and progressive behavior of head, neck, oral and maxillofacial (HNOMF) squamous cell carcinoma (SCC) has been suggested to be a multistep and multifactorial procedure that necessitates epithelial hyperplasia, epithelial dysplasia, micro invasive squamous cell carcinoma (MISCC) and early invasive squamous cell carcinoma (EISCC); EISCC and MISCC might have a completely different behavior and development process. There are only a limited number of reported HNOMF cases of EISCC or MISCC. There are still no guidelines for the treatment of EISCC and MISCC lesions in the HNOMF regions. MATERIAL AND METHODS This systematic review was conducted to gather all surgical and non-surgical treatments for EISCC and MISCC lesions in the HNOMF. The study question according to the PICO format was as followed: clinical and histopathological results (O) of all types of treatments (I) for patients with EISCC and MISCC lesions in HNOMF (P) compared to untreated lesions (C). Medline, Scopus, and Google Scholar were searched and the search was limited to English-language. RESULTS Eight clinical human studies were included. Photodynamic therapy (PDT) after topical application of methyl aminolevulinate (MAL-PDT) and topical Imiquimod 5% cream both had remarkable outcomes. CONCLUSIONS However, due to the very limited number of studies conducted on the treatment methods of MISCC and EISCC in the HNOMF regions, further studies are necessary to provide reliability for non-surgical treatment methods.