Should infranotch T4b oral cavity cancer be downstage to T4a category?

IF 2.2 3区医学 Q2 OTORHINOLARYNGOLOGY

European Archives of Oto-Rhino-Laryngology Pub Date : 2025-07-01 Epub Date: 2025-04-26 DOI:10.1007/s00405-025-09395-9

Remo Accorona, Pietro Perotti, Armando De Virgilio

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引用次数: 0

Abstract

Purpose: This comment aims to discuss the reliability of a radical resection of T4b oral squamous cell carcinomas with masticatory space involvement as well as analyze data in the literature on the oncologic outcomes compared to T4a.

Methods: Clinical review of the scientific literature with focus on oral squamous cell carcinomas with masticatory space involvement.

Results: The clinical review comprised 10 studies. The masticatory space is subdivided into infra- and supra-notch spaces according to the plane passing through the mandibular notch. En-bloc resection with compartmental approach demonstrated similar outcomes for infra-notch T4b oral cancers and T4a category.

Conclusion: En-bloc compartmental resection of the masticatory space provides the best chances of margins control. Surgery should be considered the first line treatment option for this "borderline operable" category of cancers. Comparable survival outcomes between T4a and infra-notch T4b pushed several authors to suggest the downstaging the masticatory space involvement in oral cancer to T4a category.

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早期T4b型口腔癌应该降至T4a型吗？

目的：本评论旨在探讨T4b口腔鳞状细胞癌伴咀嚼间隙累及的根治性切除的可靠性，并分析文献中与T4a相比的肿瘤预后数据。方法：回顾口腔鳞状细胞癌累及咀嚼间隙的临床文献。结果：临床综述包括10项研究。咀嚼空间根据穿过下颌切迹的平面分为切迹上和切迹下。在缺口下T4b型口腔癌和T4a型口腔癌中，采用区室入路的整体切除显示出相似的结果。结论：咀嚼间隙整体切除是控制咀嚼间隙的最佳方法。对于这种“边缘可手术”类型的癌症，手术应被视为一线治疗选择。T4a和低notch T4b的生存率比较，促使一些作者提出口腔癌中咀嚼间隙受损伤降低到T4a类别。

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

European Archives of Oto-Rhino-Laryngology 医学-耳鼻喉科学

CiteScore

5.30

自引率

7.70%

发文量

537

审稿时长

2-4 weeks

期刊介绍： Official Journal of European Union of Medical Specialists – ORL Section and Board Official Journal of Confederation of European Oto-Rhino-Laryngology Head and Neck Surgery "European Archives of Oto-Rhino-Laryngology" publishes original clinical reports and clinically relevant experimental studies, as well as short communications presenting new results of special interest. With peer review by a respected international editorial board and prompt English-language publication, the journal provides rapid dissemination of information by authors from around the world. This particular feature makes it the journal of choice for readers who want to be informed about the continuing state of the art concerning basic sciences and the diagnosis and management of diseases of the head and neck on an international level. European Archives of Oto-Rhino-Laryngology was founded in 1864 as "Archiv für Ohrenheilkunde" by A. von Tröltsch, A. Politzer and H. Schwartze.