Removing the Taboo on the Surgical Violation (Cut-Through) of Cancer

被引：13

作者：

Robbins, K. Thomas ^{[1
]}

Bradford, Carol R. ^{[2
]}

Rodrigo, Juan P. ^{[3
,4
]}

Suarez, Carlos ^{[4
,5
]}

de Bree, Remco ^{[6
]}

Kowalski, Luiz P. ^{[7
]}

Rinaldo, Alessandra ^{[8
]}

Silver, Carl E. ^{[9
,10
]}

Lund, Valerie J. ^{[11
]}

Nibu, Ken-ichi ^{[12
]}

Ferlito, Alfio

机构：

[1] Southern Illinois Univ, Div Otolaryngol Head & Neck Surg, Springfield, IL USA

[2] Univ Michigan Hlth Syst, Dept Otolaryngol Head & Neck Surg, Ann Arbor, MI USA

[3] Hosp Univ Cent Asturias, Dept Otolaryngol, Oviedo, Spain

[4] Univ Oviedo, Inst Univ Oncol Principado Asturias, Oviedo, Spain

[5] Fdn Invest & Innovac Biosanitaria Principado Astu, Oviedo, Spain

[6] Univ Med Ctr Utrecht, UMC Utrecht Canc Ctr, Dept Head & Neck Surg Oncol, Utrecht, Netherlands

[7] AC Camargo Canc Ctr, Dept Head & Neck Surg & Otorhinolaryngol, Sao Paulo, Brazil

[8] Univ Udine, Sch Med, Udine, Italy

[9] Montefiore Med Ctr, Albert Einstein Coll Med, Dept Surg, Bronx, NY 10467 USA

[10] Montefiore Med Ctr, Albert Einstein Coll Med, Dept Otolaryngol Head & Neck Surg, Bronx, NY 10467 USA

[11] UCL, Ear Inst, Professorial Unit, London, England

[12] Kobe Univ, Grad Sch Med, Dept Otolaryngol Head & Neck Surg, Kobe, Hyogo, Japan

来源：

JAMA OTOLARYNGOLOGY-HEAD & NECK SURGERY | 2016年 / 142卷 / 10期

关键词：

TRANSORAL LASER MICROSURGERY; SURGERY; CARCINOMA; TUMORS; RESECTION; SINUSES;

D O I：

10.1001/jamaoto.2016.1826

中图分类号：

R76 [耳鼻咽喉科学];

学科分类号：

100213 ;

摘要：

IMPORTANCE The surgical dictum of en bloc resection without violating cancer tissue has been challenged by novel treatments in head and neck cancer. OBSERVATIONS An analysis of treatment outcomes involving piecemeal removal of sinonasal, laryngeal, oropharyngeal, and hypopharyngeal cancer shows that it did not compromise tumor control. The rationale for the evolution toward use of this technique is outlined. CONCLUSIONS AND RELEVANCE While complete resection with clear margins remains a key end point in surgical oncology, we believe it is time to acknowledge that this time-honored dictum of avoiding tumor violation is no longer valid in selected situations.

引用

页码：1010 / 1013

页数：4

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