舌根粘液切除术在原发灶不明的鳞状细胞癌检查中的价值：一项丹麦全国队列研究。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2024-10-30 DOI:10.1016/j.oraloncology.2024.107083

Signe Bergliot Nielsen , Mikkel Hjordt Holm Larsen , Hani Ibrahim Channir , Katalin Kiss , Benedicte Parm Ulhøi , Christian Godballe , Jesper Grau Eriksen , Niclas Rubek , Thomas Kjaergaard , Christian von Buchwald

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引用次数: 0

摘要

导言：头颈部原发灶不明的鳞状细胞癌（HNSCCUP）仍是诊断难题。通过经口机器人手术（TORS-TBM）进行舌根粘液切除术可提高诊断率并减轻治疗强度。然而，TORS-TBM 作为 HNSCCUP 检查项目的辅助手段，其附加价值尚不明确。目的：本研究的主要目的是以丹麦国家指南为例，评估作为标准化检查项目补充的 TORS-TBM 的诊断率。次要目的包括 HPV 检测和 PET/CT 的预测值：这是一项全国多中心观察性队列研究，包括2013年1月至2019年12月期间诊断为HNSCCUP的所有患者，他们随后都接受了TORS-TBM检查。在大多数情况下，HPV 状态基于双重检测（p16 和 HPV-DNA）。计算了 PET/CT 和 HPV 状态的预测值：共有100名患者连续接受了TORS-TBM手术，其中93例为全侧TBM，7例为单侧TBM。49%的患者（49/100）发现了原发肿瘤。HPV相关疾病患者的检出率为58%（47/81）（HPV状态的PPV），HPV独立疾病患者的检出率为11%（2/19）。HPV状态的NPV为89%。PET/CT 的 PPV 和 NPV 分别为 53% 和 52%：在目前丹麦基于指南的HNCCCUP患者HPV相关疾病检查项目中加入全TORS-TBM，可显著提高诊断率。

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The value of tongue base mucosectomy in the work-up of squamous cell carcinoma of unknown primary: A Danish national cohort study

Introduction

Squamous cell carcinoma of unknown primary in the head and neck (HNSCCUP) remains a diagnostic challenge. Tongue base mucosectomy by transoral robotic surgery (TORS-TBM) can increase the diagnostic yield and de-intensify treatment. However, the added value of TORS-TBM as an adjunct to work-up programs for HNSCCUP is unclear. Furthermore, the optimal extent of the procedure and selection criteria remain to be established.

Aim

The primary aim of the present study was to assess the diagnostic yield of TORS-TBM as a supplement to a standardized work-up program, using the Danish national guidelines as an example. Secondary aims include predictive values of HPV-testing and PET/CT.

Methods

This was a national multicenter observational cohort study including all patients diagnosed with HNSCCUP from January 2013 to December 2019, who subsequently underwent TORS-TBM. In most cases HPV status was based on dual testing (p16 and HPV-DNA). Predictive values of PET/CT and HPV status were calculated.

Results

A total of 100 consecutive patients underwent TORS-TBM; 93 total TBMs and 7 unilateral TBMs. The primary tumor was detected in 49 % (49/100) of patients. The detection rate was 58 % (47/81) in patients with HPV-associated disease (PPV of HPV status) and 11 % (2/19) in patients with HPV-independent disease. The NPV of HPV status was 89 %. The PPV and NPV of PET/CT was 53 % and 52 %, respectively.

Conclusion

Adding total TORS-TBM to the current Danish guideline-based work-up program on HNCCCUP patients with HPV-associated disease significantly improved the diagnostic yield.

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.

舌根粘液切除术在原发灶不明的鳞状细胞癌检查中的价值： 一项丹麦全国队列研究。

摘要

Introduction

Aim

Methods

Results

Conclusion

舌根粘液切除术在原发灶不明的鳞状细胞癌检查中的价值：一项丹麦全国队列研究。