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Will the mininvasive approach challenge the old paradigms in oral cancer surgery?

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Abstract

In the genome era, the achievement of a safe and complete resection of oral cancers remains a challenge for surgeons. Margin length at histopathological examination is still considered the main indicator of oncological radicality. However, this parameter is fraught by major limitations. Cancer aggressiveness, and in particular its ability to spread in the surrounding tissue, most probably influences loco-regional control and prognosis more than margin length. Unfortunately, no molecular markers are currently available to predict tumor aggressiveness pre-operatively. However, additional histopathological parameters, beside margin length, could be considered to better stratify oral tumors, including depth of invasion (DOI), perineural invasion or composite scores. Recent advances in laser technology have established a novel surgical trend toward a minimalist approach, named transoral laser microsurgery (TLM). TLM provides a local control rate comparable to the one achieved by larger resections if the margin appears disease free, independent from its length. In addition, the clinical availability of innovative optical technologies, such as narrow band imaging (NBI) or autofluorescence, allows more precise and tailored resections, not simply based on clinical observation and ruler measurement. This review will propose the possible implementation of novel procedures toward a mini-invasive surgical approach, providing a satisfactory control rate but significantly improving the quality of life of the patients compared to conventional surgery.

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References

  1. Meier JD, Oliver DA, Varvares MA (2005) Surgical margin determination in head and neck oncology: current clinical practice. The results of an International American Head and Neck Society Member Survey. Head Neck 27(11):952–958

    Article  PubMed  Google Scholar 

  2. Slootweg PJ et al (2002) Treatment failure and margin status in head and neck cancer. A critical view on the potential value of molecular pathology. Oral Oncol 38(5):500–503

    Article  PubMed  Google Scholar 

  3. Al-Rajhi N et al (2000) Early stage carcinoma of oral tongue: prognostic factors for local control and survival. Oral Oncol 36(6):508–514

    Article  CAS  PubMed  Google Scholar 

  4. Brandwein-Gensler M et al (2005) Oral squamous cell carcinoma: histologic risk assessment, but not margin status, is strongly predictive of local disease-free and overall survival. Am J Surg Pathol 29(2):167–178

    Article  PubMed  Google Scholar 

  5. Jerjes W et al (2010) Clinicopathological parameters, recurrence, locoregional and distant metastasis in 115 T1-T2 oral squamous cell carcinoma patients. Head Neck Oncol 2:9

    Article  PubMed  PubMed Central  Google Scholar 

  6. Binmadi NO, Basile JR (2011) Perineural invasion in oral squamous cell carcinoma: a discussion of significance and review of the literature. Oral Oncol 47(11):1005–1010

    Article  PubMed  Google Scholar 

  7. Steiner W (1994) Therapy of hypopharyngeal cancer. Part III: the concept of minimally invasive therapy of cancers of the upper aerodigestive tract with special reference to hypopharyngeal cancer and trans-oral laser microsurgery. HNO 42(2):104–112

    CAS  PubMed  Google Scholar 

  8. Hinni ML, Zarka MA, Hoxworth JM (2013) Margin mapping in transoral surgery for head and neck cancer. Laryngoscope 123(5):1190–1198

    Article  PubMed  Google Scholar 

  9. Strong MS, Jako GJ (1972) Laser surgery in the larynx. Early clinical experience with continuous CO2 laser. Ann Otol Rhinol Laryngol 81(6):791–798

    Article  CAS  PubMed  Google Scholar 

  10. Lingen MW et al (2008) Critical evaluation of diagnostic aids for the detection of oral cancer. Oral Oncol 44(1):10–22

    Article  PubMed  Google Scholar 

  11. Munoz Guerra MF et al (2003) Marginal and segmental mandibulectomy in patients with oral cancer: a statistical analysis of 106 cases. J Oral Maxillofac Surg 61(11):1289–1296

    Article  PubMed  Google Scholar 

  12. Weinberg RA (2013) The biology of cancer. Taylor and Francis Group, New York

    Google Scholar 

  13. Viet CT, Schmidt BL (2010) Understanding oral cancer in the genome era. Head Neck 32(9):1246–1268

    Article  PubMed  Google Scholar 

  14. Boscolo-Rizzo P et al (2015) Telomere shortening in mucosa surrounding the tumor: biosensor of field cancerization and prognostic marker of mucosal failure in head and neck squamous cell carcinoma. Oral Oncol 51(5):500–507

    Article  CAS  PubMed  Google Scholar 

  15. Reis PP et al (2011) A gene signature in histologically normal surgical margins is predictive of oral carcinoma recurrence. BMC Cancer 11:437

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Woolgar JA, Triantafyllou A (2005) A histopathological appraisal of surgical margins in oral and oropharyngeal cancer resection specimens. Oral Oncol 41(10):1034–1043

    Article  PubMed  Google Scholar 

  17. Binahmed A, Nason RW, Abdoh AA (2007) The clinical significance of the positive surgical margin in oral cancer. Oral Oncol 43(8):780–784

    Article  PubMed  Google Scholar 

  18. Wong LS et al (2012) Influence of close resection margins on local recurrence and disease-specific survival in oral and oropharyngeal carcinoma. Br J Oral Maxillofac Surg 50(2):102–108

    Article  PubMed  Google Scholar 

  19. Dillon JK et al (2015) How does the close surgical margin impact recurrence and survival when treating oral squamous cell carcinoma? J Oral Maxillofac Surg 73(6):1182–1188

    Article  PubMed  Google Scholar 

  20. Anderson CR, Sisson K, Moncrieff M (2015) A meta-analysis of margin size and local recurrence in oral squamous cell carcinoma. Oral Oncol 51(5):464–469

    Article  PubMed  Google Scholar 

  21. Varvares MA et al (2015) Surgical margins and primary site resection in achieving local control in oral cancer resections. Laryngoscope 125(10):2298–2307

    Article  PubMed  Google Scholar 

  22. Looser KG, Shah JP, Strong EW (1978) The significance of “positive” margins in surgically resected epidermoid carcinomas. Head Neck Surg 1(2):107–111

    Article  CAS  PubMed  Google Scholar 

  23. Loree TR, Strong EW (1990) Significance of positive margins in oral cavity squamous carcinoma. Am J Surg 160(4):410–414

    Article  CAS  PubMed  Google Scholar 

  24. Spiro RH et al (1999) Pattern of invasion and margin assessment in patients with oral tongue cancer. Head Neck 21(5):408–413

    Article  CAS  PubMed  Google Scholar 

  25. McMahon J et al (2003) Influence of condition of surgical margins on local recurrence and disease-specific survival in oral and oropharyngeal cancer. Br J Oral Maxillofac Surg 41(4):224–231

    Article  CAS  PubMed  Google Scholar 

  26. Sieczka E et al (2001) Cancer of the buccal mucosa: are margins and T-stage accurate predictors of local control? Am J Otolaryngol 22(6):395–399

    Article  CAS  PubMed  Google Scholar 

  27. Shim SJ et al (2010) Clinical outcomes for T1-2N0-1 oral tongue cancer patients underwent surgery with and without postoperative radiotherapy. Radiat Oncol 5:43

    Article  PubMed  PubMed Central  Google Scholar 

  28. Barry CP et al (2013) De-escalation of surgery for early oral cancer—is it oncologically safe? Br J Oral Maxillofac Surg 51(1):30–36

    Article  PubMed  Google Scholar 

  29. Alicandri-Ciufelli M et al (2013) Surgical margins in head and neck squamous cell carcinoma: what is ‘close’? Eur Arch Otorhinolaryngol 270(10):2603–2609

    Article  PubMed  Google Scholar 

  30. Vered M et al (2010) Oral tongue squamous cell carcinoma: recurrent disease is associated with histopathologic risk score and young age. J Cancer Res Clin Oncol 136(7):1039–1048

    Article  PubMed  Google Scholar 

  31. Zelefsky MJ et al (1990) Postoperative radiotherapy for oral cavity cancers: impact of anatomic subsite on treatment outcome. Head Neck 12(6):470–475

    Article  CAS  PubMed  Google Scholar 

  32. Weijers M et al (2004) The status of the deep surgical margins in tongue and floor of mouth squamous cell carcinoma and risk of local recurrence; an analysis of 68 patients. Int J Oral Maxillofac Surg 33(2):146–149

    Article  CAS  PubMed  Google Scholar 

  33. Gokavarapu S et al (2014) Close margins in oral cancers: implication of close margin status in recurrence and survival of pT1N0 and pT2N0 oral cancers. Int J Surg Oncol 2014:545372

    PubMed  PubMed Central  Google Scholar 

  34. Nason RW et al (2009) What is the adequate margin of surgical resection in oral cancer? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107(5):625–629

    Article  PubMed  Google Scholar 

  35. Dixit S et al (1998) Surgery versus surgery and postoperative radiotherapy in squamous cell carcinoma of the buccal mucosa: a comparative study. Ann Surg Oncol 5(6):502–510

    Article  CAS  PubMed  Google Scholar 

  36. Liao CT et al (2008) Analysis of risk factors of predictive local tumor control in oral cavity cancer. Ann Surg Oncol 15(3):915–922

    Article  PubMed  Google Scholar 

  37. van Es RJ et al (1996) Resection margin as a predictor of recurrence at the primary site for T1 and T2 oral cancers. Evaluation of histopathologic variables. Arch Otolaryngol Head Neck Surg 122(5):521–525

    Article  PubMed  Google Scholar 

  38. Dik EA et al (2014) Resection of early oral squamous cell carcinoma with positive or close margins: relevance of adjuvant treatment in relation to local recurrence: margins of 3 mm as safe as 5 mm. Oral Oncol 50(6):611–615

    Article  PubMed  Google Scholar 

  39. Ampil FL et al (2003) Postoperative radiotherapy for insecure or positive surgical margins in head and neck cancer. J Oral Maxillofac Surg 61(4):425–429

    Article  PubMed  Google Scholar 

  40. Sutton DN et al (2003) The prognostic implications of the surgical margin in oral squamous cell carcinoma. Int J Oral Maxillofac Surg 32(1):30–34

    Article  CAS  PubMed  Google Scholar 

  41. Patel RS et al (2010) Impact of positive frozen section microscopic tumor cut-through revised to negative on oral carcinoma control and survival rates. Head Neck 32(11):1444–1451

    Article  PubMed  Google Scholar 

  42. Kovacs AF (2004) Relevance of positive margins in case of adjuvant therapy of oral cancer. Int J Oral Maxillofac Surg 33(5):447–453

    Article  CAS  PubMed  Google Scholar 

  43. Kurita H et al (2010) Impact of different surgical margin conditions on local recurrence of oral squamous cell carcinoma. Oral Oncol 46(11):814–817

    Article  PubMed  Google Scholar 

  44. Woolgar JA, Triantafyllou A (2009) Pitfalls and procedures in the histopathological diagnosis of oral and oropharyngeal squamous cell carcinoma and a review of the role of pathology in prognosis. Oral Oncol 45(4–5):361–385

    Article  PubMed  Google Scholar 

  45. Jakobsson PA et al (1973) Histologic classification and grading of malignancy in carcinoma of the larynx. Acta Radiol Ther Phys Biol 12(1):1–8

    Article  CAS  PubMed  Google Scholar 

  46. Anneroth G, Batsakis J, Luna M (1987) Review of the literature and a recommended system of malignancy grading in oral squamous cell carcinomas. Scand J Dent Res 95(3):229–249

    CAS  PubMed  Google Scholar 

  47. Bryne M et al (1989) New malignancy grading is a better prognostic indicator than Broders’ grading in oral squamous cell carcinomas. J Oral Pathol Med 18(8):432–437

    Article  CAS  PubMed  Google Scholar 

  48. Anneroth G, Hansen LS (1984) A methodologic study of histologic classification and grading of malignancy in oral squamous cell carcinoma. Scand J Dent Res 92(5):448–468

    CAS  PubMed  Google Scholar 

  49. Bryne M et al (1992) Malignancy grading of the deep invasive margins of oral squamous cell carcinomas has high prognostic value. J Pathol 166(4):375–381

    Article  CAS  PubMed  Google Scholar 

  50. Groome PA et al (2001) A comparison of published head and neck stage groupings in carcinomas of the oral cavity. Head Neck 23(8):613–624

    Article  CAS  PubMed  Google Scholar 

  51. Kreppel M et al (2011) Prognostic impact of different TNM-based stage groupings for oral squamous cell carcinoma. Head Neck 33(10):1467–1475

    Article  PubMed  Google Scholar 

  52. International Consortium for Outcome Research (ICOR) in Head and Neck Cancer, Ebrahimi A, Gil Z et al (2014) Primary tumor staging for oral cancer and a proposed modification incorporating depth of invasion: an international multicenter retrospective study. JAMA Otolaryngol Head Neck Surg 140(12):1138–1148

    Article  Google Scholar 

  53. Almangush A et al (2014) Depth of invasion, tumor budding, and worst pattern of invasion: prognostic indicators in early-stage oral tongue cancer. Head Neck 36(6):811–818

    Article  PubMed  Google Scholar 

  54. Ganly I et al (2013) Long-term regional control and survival in patients with “low-risk,” early stage oral tongue cancer managed by partial glossectomy and neck dissection without postoperative radiation: the importance of tumor thickness. Cancer 119(6):1168–1176

    Article  PubMed  Google Scholar 

  55. Ling W, Mijiti A, Moming A (2013) Survival pattern and prognostic factors of patients with squamous cell carcinoma of the tongue: a retrospective analysis of 210 cases. J Oral Maxillofac Surg 71(4):775–785

    Article  PubMed  Google Scholar 

  56. Clark JR et al (2006) Established prognostic variables in N0 oral carcinoma. Otolaryngol Head Neck Surg 135(5):748–753

    Article  PubMed  Google Scholar 

  57. O-charoenrat P et al (2003) Tumour thickness predicts cervical nodal metastases and survival in early oral tongue cancer. Oral Oncol 39(4):386–390

    Article  CAS  PubMed  Google Scholar 

  58. Rahima B et al (2004) Prognostic significance of perineural invasion in oral and oropharyngeal carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 97(4):423–431

    Article  PubMed  Google Scholar 

  59. Woolgar JA (2006) Histopathological prognosticators in oral and oropharyngeal squamous cell carcinoma. Oral Oncol 42(3):229–239

    Article  PubMed  Google Scholar 

  60. Woolgar JA, Scott J (1995) Prediction of cervical lymph node metastasis in squamous cell carcinoma of the tongue/floor of mouth. Head Neck 17(6):463–472

    Article  CAS  PubMed  Google Scholar 

  61. Tadbir AA, Ashraf MJ, Sardari Y (2009) Prognostic significance of stromal eosinophilic infiltration in oral squamous cell carcinoma. J Craniofac Surg 20(2):287–289

    Article  PubMed  Google Scholar 

  62. Li Y et al (2013) Validation of the risk model: high-risk classification and tumor pattern of invasion predict outcome for patients with low-stage oral cavity squamous cell carcinoma. Head Neck Pathol 7(3):211–223

    Article  CAS  PubMed  Google Scholar 

  63. Brandwein-Gensler M et al (2010) Validation of the histologic risk model in a new cohort of patients with head and neck squamous cell carcinoma. Am J Surg Pathol 34(5):676–688

    PubMed  Google Scholar 

  64. Upile T et al (2007) The uncertainty of the surgical margin in the treatment of head and neck cancer. Oral Oncol 43(4):321–326

    Article  CAS  PubMed  Google Scholar 

  65. Cheng A, Cox D, Schmidt BL (2008) Oral squamous cell carcinoma margin discrepancy after resection and pathologic processing. J Oral Maxillofac Surg 66(3):523–529

    Article  PubMed  Google Scholar 

  66. Batsakis JG (1999) Surgical excision margins: a pathologist’s perspective. Adv Anat Pathol 6(3):140–148

    Article  CAS  PubMed  Google Scholar 

  67. Boonstra H et al (1983) Cervical tissue shrinkage by formaldehyde fixation, paraffin wax embedding, section cutting and mounting. Virchows Arch A Pathol Anat Histopathol 402(2):195–201

    Article  CAS  PubMed  Google Scholar 

  68. Siu KF, Cheung HC, Wong J (1986) Shrinkage of the esophagus after resection for carcinoma. Ann Surg 203(2):173–176

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Goldstein NS, Soman A, Sacksner J (1999) Disparate surgical margin lengths of colorectal resection specimens between in vivo and in vitro measurements. The effects of surgical resection and formalin fixation on organ shrinkage. Am J Clin Pathol 111(3):349–351

    Article  CAS  PubMed  Google Scholar 

  70. Lindboe CF (2011) Lymph node harvest in colorectal adenocarcinoma specimens: the impact of improved fixation and examination procedures. APMIS 119(6):347–355

    Article  PubMed  Google Scholar 

  71. Mistry RC, Qureshi SS, Kumaran C (2005) Post-resection mucosal margin shrinkage in oral cancer: quantification and significance. J Surg Oncol 91(2):131–133

    Article  PubMed  Google Scholar 

  72. El-Fol HA et al (2015) Significance of post-resection tissue shrinkage on surgical margins of oral squamous cell carcinoma. J Craniomaxillofac Surg 43(4):475–482

    Article  PubMed  Google Scholar 

  73. Woolgar JA et al (1999) Survival and patterns of recurrence in 200 oral cancer patients treated by radical surgery and neck dissection. Oral Oncol 35(3):257–265

    Article  CAS  PubMed  Google Scholar 

  74. Parsons JT, Cassisi NJ, Million RR (1984) Results of twice-a-day irradiation of squamous cell carcinomas of the head and neck. Int J Radiat Oncol Biol Phys 10(11):2041–2051

    Article  CAS  PubMed  Google Scholar 

  75. Kreppel M et al (2013) The role of clinical versus histopathological staging in patients with advanced oral squamous cell carcinoma treated with neoadjuvant radiochemotherapy followed by radical surgery. J Craniomaxillofac Surg 41(1):22–27

    Article  PubMed  Google Scholar 

  76. Leong AS, Gilham PN (1989) The effects of progressive formaldehyde fixation on the preservation of tissue antigens. Pathology 21(4):266–268

    Article  CAS  PubMed  Google Scholar 

  77. Hsu PK et al (2007) Effect of formalin fixation on tumor size determination in stage I non-small cell lung cancer. Ann Thorac Surg 84(6):1825–1829

    Article  PubMed  Google Scholar 

  78. Chen CH et al (2012) Shrinkage of head and neck cancer specimens after formalin fixation. J Chin Med Assoc 75(3):109–113

    Article  PubMed  Google Scholar 

  79. Vent J et al (2014) Influence of formalin fixation on tissue dimensions in palatal tonsils. Pathol Res Pract 210(1):59–61

    Article  CAS  PubMed  Google Scholar 

  80. Brotherston D et al (2015) Tumor shrinkage associated with whole-mount histopathologic techniques in oral tongue carcinoma. Pathol Res Pract 211(5):398–403

    Article  PubMed  Google Scholar 

  81. Dahele M et al (2008) Developing a methodology for three-dimensional correlation of PET-CT images and whole-mount histopathology in non-small-cell lung cancer. Curr Oncol 15(5):62–69

    CAS  PubMed  PubMed Central  Google Scholar 

  82. Guillem JG et al (2007) A prospective pathologic analysis using whole-mount sections of rectal cancer following preoperative combined modality therapy: implications for sphincter preservation. Ann Surg 245(1):88–93

    Article  PubMed  PubMed Central  Google Scholar 

  83. Hinni ML et al (2013) Surgical margins in head and neck cancer: a contemporary review. Head Neck 35(9):1362–1370

    Article  PubMed  Google Scholar 

  84. Tirelli G et al (2015) Open questions and novel concepts in oral cancer surgery. Eur Arch Otorhinolaryngol. doi:10.1007/s00405-015-3695-5

  85. Gil Z, Fliss DM (2009) Contemporary management of head and neck cancers. Isr Med Assoc J 11(5):296–300

    PubMed  Google Scholar 

  86. Calabrese L et al (2013) From wide excision to a compartmental approach in tongue tumors: what is going on? Curr Opin Otolaryngol Head Neck Surg 21(2):112–117

    Article  PubMed  Google Scholar 

  87. Calabrese L et al (2011) Compartmental tongue surgery: long term oncologic results in the treatment of tongue cancer. Oral Oncol 47(3):174–179

    Article  PubMed  Google Scholar 

  88. Steiner W (1993) Results of curative laser microsurgery of laryngeal carcinomas. Am J Otolaryngol 14(2):116–121

    Article  CAS  PubMed  Google Scholar 

  89. Haughey BH et al (2011) Transoral laser microsurgery as primary treatment for advanced-stage oropharyngeal cancer: a United States multicenter study. Head Neck 33(12):1683–1694

    Article  PubMed  Google Scholar 

  90. Sinha P et al (2014) Transoral laser microsurgery for oral squamous cell carcinoma: oncologic outcomes and prognostic factors. Head Neck 36(3):340–351

    Article  PubMed  Google Scholar 

  91. Sinha P et al (2015) Histologic and systemic prognosticators for local control and survival in margin-negative transoral laser microsurgery treated oral cavity squamous cell carcinoma. Head Neck 37(1):52–63

    Article  PubMed  Google Scholar 

  92. Rich JT, Liu J, Haughey BH (2011) Swallowing function after transoral laser microsurgery (TLM) ± adjuvant therapy for advanced-stage oropharyngeal cancer. Laryngoscope 121(11):2381–2390

    Article  PubMed  PubMed Central  Google Scholar 

  93. O’Hara J et al (2015) Transoral laser microsurgery ± adjuvant therapy versus chemoradiotherapy for stage III and IVA oropharyngeal squamous cell carcinoma: preliminary comparison of early swallowing outcomes. Head Neck 37(10):1488–1494

    Article  PubMed  Google Scholar 

  94. Tateya I et al (2016) Transoral surgery for laryngo-pharyngeal cancer—the paradigm shift of the head and cancer treatment. Auris Nasus Larynx 43(1):21–32

    Article  PubMed  Google Scholar 

  95. Eckel HE et al (1995) Transoral laser resection with staged discontinuous neck dissection for oral cavity and oropharynx squamous cell carcinoma. Laryngoscope 105(1):53–60

    Article  CAS  PubMed  Google Scholar 

  96. Jerjes W et al (2011) Prospective evaluation of outcome after transoral CO(2) laser resection of T1/T2 oral squamous cell carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 112(2):180–187

    Article  PubMed  Google Scholar 

  97. Canis M et al (2014) Enoral laser microsurgery for squamous cell carcinoma of the oral cavity. Head Neck 36(6):787–794

    Article  PubMed  Google Scholar 

  98. Goldstein DP et al (2013) Outcomes of squamous cell cancer of the oral tongue managed at the Princess Margaret Hospital. Head Neck 35(5):632–641

    Article  PubMed  Google Scholar 

  99. Hicks WL Jr et al (1997) Squamous cell carcinoma of the floor of mouth: a 20-year review. Head Neck 19(5):400–405

    Article  PubMed  Google Scholar 

  100. Spiro RH, Spiro JD, Strong EW (1986) Surgical approach to squamous carcinoma confined to the tongue and the floor of the mouth. Head Neck Surg 9(1):27–31

    Article  CAS  PubMed  Google Scholar 

  101. Kroll SS et al (1996) Choice of flap and incidence of free flap success. Plast Reconstr Surg 98(3):459–463

    Article  CAS  PubMed  Google Scholar 

  102. Marchetta FC, Sako K, Murphy JB (1971) The periosteum of the mandible and intraoral carcinoma. Am J Surg 122(6):711–713

    Article  CAS  PubMed  Google Scholar 

  103. Genden EM et al (2010) Contemporary management of cancer of the oral cavity. Eur Arch Otorhinolaryngol 267(7):1001–1017

    Article  PubMed  PubMed Central  Google Scholar 

  104. Slootweg PJ, Muller H (1989) Mandibular invasion by oral squamous cell carcinoma. J Craniomaxillofac Surg 17(2):69–74

    Article  CAS  PubMed  Google Scholar 

  105. Chen YL et al (2011) Prognostic impact of marginal mandibulectomy in the presence of superficial bone invasion and the nononcologic outcome. Head Neck 33(5):708–713

    Article  PubMed  Google Scholar 

  106. Wong RJ et al (2000) Histological pattern of mandibular invasion by oral squamous cell carcinoma. Laryngoscope 110(1):65–72

    Article  CAS  PubMed  Google Scholar 

  107. Brown J (2003) Mechanisms of cancer invasion of the mandible. Curr Opin Otolaryngol Head Neck Surg 11(2):96–102

    Article  PubMed  Google Scholar 

  108. Bolzoni A et al (2004) Diagnostic accuracy of magnetic resonance imaging in the assessment of mandibular involvement in oral-oropharyngeal squamous cell carcinoma: a prospective study. Arch Otolaryngol Head Neck Surg 130(7):837–843

    Article  PubMed  Google Scholar 

  109. Hakim SG et al (2014) Imaging of mandible invasion by oral squamous cell carcinoma using computed tomography, cone-beam computed tomography and bone scintigraphy with SPECT. Clin Oral Investig 18(3):961–967

    Article  PubMed  Google Scholar 

  110. Momin MA et al (2009) Diagnostic accuracy of cone-beam CT in the assessment of mandibular invasion of lower gingival carcinoma: comparison with conventional panoramic radiography. Eur J Radiol 72(1):75–81

    Article  PubMed  Google Scholar 

  111. Mukherji SK et al (2001) CT detection of mandibular invasion by squamous cell carcinoma of the oral cavity. AJR Am J Roentgenol 177(1):237–243

    Article  CAS  PubMed  Google Scholar 

  112. Imaizumi A et al (2006) A potential pitfall of MR imaging for assessing mandibular invasion of squamous cell carcinoma in the oral cavity. AJNR Am J Neuroradiol 27(1):114–122

    CAS  PubMed  Google Scholar 

  113. Van Cann EM et al (2008) Quantitative dynamic contrast-enhanced MRI for the assessment of mandibular invasion by squamous cell carcinoma. Oral Oncol 44(12):1147–1154

    Article  PubMed  Google Scholar 

  114. Babin E et al (2008) PET/CT for assessing mandibular invasion by intraoral squamous cell carcinomas. Clin Otolaryngol 33(1):47–51

    Article  CAS  PubMed  Google Scholar 

  115. Gu DH et al (2010) CT, MR (18)F-FDG PET/CT, and their combined use for the assessment of mandibular invasion by squamous cell carcinomas of the oral cavity. Acta Radiol 51(10):1111–1119

    Article  PubMed  Google Scholar 

  116. Pandey M, Rao LP, Das SR (2009) Predictors of mandibular involvement in cancers of the oromandibular region. J Oral Maxillofac Surg 67(5):1069–1073

    Article  PubMed  Google Scholar 

  117. Brown JS, Lewis-Jones H (2001) Evidence for imaging the mandible in the management of oral squamous cell carcinoma: a review. Br J Oral Maxillofac Surg 39(6):411–418

    Article  CAS  PubMed  Google Scholar 

  118. Lin YC et al (2012) Value of narrow band imaging endoscopy in early mucosal head and neck cancer. Head Neck 34(11):1574–1579

    Article  PubMed  Google Scholar 

  119. Lee M et al (2011) Construct optimization for studying protein complexes: obtaining diffraction-quality crystals of the pseudosymmetric PSPC1-NONO heterodimer. Acta Crystallogr D Biol Crystallogr 67(Pt 11):981–987

    Article  CAS  PubMed  Google Scholar 

  120. Jerjes W et al (2010) In vitro examination of suspicious oral lesions using optical coherence tomography. Br J Oral Maxillofac Surg 48(1):18–25

    Article  PubMed  Google Scholar 

  121. Hamdoon Z et al (2015) Optical coherence tomography in the assessment of oral squamous cell carcinoma resection margins. Photodiagnosis Photodyn Ther 13:211–217

    Article  PubMed  Google Scholar 

  122. Poh CF et al (2006) Fluorescence visualization detection of field alterations in tumor margins of oral cancer patients. Clin Cancer Res 12(22):6716–6722

    Article  CAS  PubMed  Google Scholar 

  123. Gono K (2015) Narrow band imaging: technology basis and research and development history. Clin Endosc 48(6):476–480

    Article  PubMed  PubMed Central  Google Scholar 

  124. Piazza C et al (2016) The diagnostic value of narrow band imaging in different oral and oropharyngeal subsites. Eur Arch Otorhinolaryngol 267(3):413–420

    Google Scholar 

  125. Piazza C et al (2010) Narrow band imaging and high definition television in the assessment of laryngeal cancer: a prospective study on 279 patients. Eur Arch Otorhinolaryngol 267(3):409–414

    Article  PubMed  Google Scholar 

  126. Vu AN, Farah CS (2014) Efficacy of narrow band imaging for detection and surveillance of potentially malignant and malignant lesions in the oral cavity and oropharynx: a systematic review. Oral Oncol 50(5):413–420

    Article  PubMed  Google Scholar 

  127. Zhang L et al (2005) Toluidine blue staining identifies high-risk primary oral premalignant lesions with poor outcome. Cancer Res 65(17):8017–8021

    CAS  PubMed  Google Scholar 

  128. Chhabra N, Chhabra S, Sapra N (2015) Diagnostic modalities for squamous cell carcinoma: an extensive review of literature-considering toluidine blue as a useful adjunct. J Maxillofac Oral Surg 14(2):188–200

    Article  PubMed  Google Scholar 

  129. Petruzzi M et al (2010) Use of Lugol’s iodine in oral cancer diagnosis: an overview. Oral Oncol 46(11):811–813

    Article  PubMed  Google Scholar 

  130. Nguyen P et al (2013) High specificity of combined narrow band imaging and autofluorescence mucosal assessment of patients with head and neck cancer. Head Neck 35(5):619–625

    Article  PubMed  Google Scholar 

  131. Takano JH et al (2010) Detecting early oral cancer: narrowband imaging system observation of the oral mucosa microvasculature. Int J Oral Maxillofac Surg 39(3):208–213

    Article  CAS  PubMed  Google Scholar 

  132. Yang SW et al (2012) Use of endoscopy with narrow-band imaging system in evaluating oral leukoplakia. Head Neck 34(7):1015–1022

    Article  PubMed  Google Scholar 

  133. Yang SW et al (2013) Light sources used in evaluating oral leukoplakia: broadband white light versus narrowband imaging. Int J Oral Maxillofac Surg 42(6):693–701

    Article  PubMed  Google Scholar 

  134. Tirelli G, Piovesana M et al (2015) Narrow band imaging in the intra-operative definition of resection margins in oral cavity and oropharyngeal cancer. Oral Oncol 51(10):908–913

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Otolaryngology and Head and Neck Surgery, Cattinara Hospital, University of Trieste, Trieste, Italy

    G. Tirelli, F. Boscolo Nata, E. Quatela & M. Piovesana

  2. Molecular Medicine, International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy

    S. Zacchigna

  3. Division of Oral Medicine and Pathology, Dental Science Department, University of Trieste, Trieste, Italy

    R. Di Lenarda

Authors
  1. G. Tirelli
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  2. S. Zacchigna
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  3. F. Boscolo Nata
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  4. E. Quatela
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  5. R. Di Lenarda
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  6. M. Piovesana
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Corresponding author

Correspondence to M. Piovesana.

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Tirelli, G., Zacchigna, S., Boscolo Nata, F. et al. Will the mininvasive approach challenge the old paradigms in oral cancer surgery?. Eur Arch Otorhinolaryngol 274, 1279–1289 (2017). https://doi.org/10.1007/s00405-016-4221-0

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  • DOI: https://doi.org/10.1007/s00405-016-4221-0

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