Understanding approaches to measurement and impact of depth of invasion of oral cavity cancers: A survey of American Head and Neck Society Membership. Oral Oncol 2019 Dec;99:104461
Date
11/05/2019Pubmed ID
31678765DOI
10.1016/j.oraloncology.2019.104461Scopus ID
2-s2.0-85074298071 (requires institutional sign-in at Scopus site) 8 CitationsAbstract
OBJECTIVES: To investigate methods used by head and neck surgeons to pre-operatively measure depth of invasion (DOI) in light of the new staging for oral cavity squamous cell carcinoma (OCSCC).
MATERIALS AND METHODS: A survey was designed and sent to all American Head and Neck Society (AHNS) members via an email link. The last response was recorded on January 16, 2019.
RESULTS: We received 185 (13.3%) responses from 184 surgeons and 1 radiation oncologist. The majority of surgeons correctly identified DOI (78.9%) and indicated measuring DOI pre-operatively (86%). The most common methods for measuring DOI were manual palpation (32.5%) and full thickness biopsy (25.2%). In addition, most surgeons (84.7%) reported using a DOI threshold (in mm) as their primary criterion in their decision to pursue a neck dissection in the N0 neck. The most common reported threshold was 4 mm (37.4% of those that reported using DOI), however, the range varied from 2 to >10 mm. Two-thirds of surgeons considered DOI an important indicator for adjuvant therapy.
CONCLUSION: DOI is believed to be an important prognostic indicator guiding neck dissection and the need for adjuvant therapy. While most surgeons currently measure DOI pre-operatively, most use subjective methods. Future studies are needed to establish objective pre-operative DOI measurement techniques and to better inform the decision to perform prophylactic neck dissection, given the current majority practice of prophylactic neck dissection for DOI of 4 mm or greater.
Author List
Bulbul MG, Zenga J, Puram SV, Tarabichi O, Parikh AS, Varvares MAAuthor
Joseph Zenga MD Assistant Professor in the Otolaryngology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
FemaleHead and Neck Neoplasms
Humans
Male
Mouth Neoplasms
Neck Dissection
Prognosis
Societies, Medical
Surveys and Questionnaires
United States
