Pull-through resection and peroral resection in early-stage T1 and T2 tongue and floor of the mouth cancers: a comparison of two techniques

Yıl 2011, Cilt: 21 Sayı: 6, 0 - 0, 09.12.2011

Nermin Başerer Murat Damar

Öz

Objectives: To compare oncological, functional, clinical and cosmetic results of peroral resection and pull-through resection in early stage T1, T2 tongue and floor of the mouth cancers. Patients and Methods: Forty-nine patients 23 females, 26 males; mean age 54.4 years; range 21 to 87 years with stage T1 and T2 oral tongue and floor of the mouth cancers primarily treated with peroral resection or pull-through resection techniques between 1998 and 2008 were included in this study. The data obtained during the study clinical follow-up, tumor stage, type of surgery were retrospectively evaluated, and the data obtained from patient follow-up relapse, speaking, eating and drinking function, cosmetic appearance, patient satisfaction were evaluated prospectively. Twenty-two patients were staged T1 and 27 patients were staged T2. Ten patients with stage T1 underwent pull-through resection, 12 patients with stage T1 underwent peroral resection. Sixteen patients with stage T2 underwent pull-through resection, 11 patients with stage T2 underwent peroral resection. Independent Samples T-test, One Way ANOVA test and Chi-Square test were used to compare these two resection techniques. Results: Cervical lymph node metastases were detected in 13 patients 27% of 49 patients with early stage T1-T2 during postoperative histopathological evaluation. The difference was statistically significant in terms of recurrence in T2 tumors p<0.05 . The recurrence rate was 26% in patients who underwent peroral resection and 3.8% in patients who underwent pull-through resection with stage T1 and T2. Although there was no significant difference when comparing patient satisfaction, cosmetic appearance and postoperative complications, a significant difference was found for nasogastric tube and prophylactic tracheotomy applications in patients who underwent pull-through resection p<0.05 . Conclusion: Pull-through resection is oncologically safer than peroral resection at the early stage T1, T2 of floor of the mouth and oral tongue carcinomas. There was no significant difference between the two techniques concerning function and cosmesis.

Anahtar Kelimeler

Peroral resection, pull-through resection, tongue and floor of the mouth floor carcinoma

Erken evre T1-T2 dil ve ağız tabanı kanserlerinde pull-through rezeksiyon ve peroral rezeksiyon: İki tekniğin karşılaştırılması

Öz

Amaç: Erken evre T1, T2 oral dil ve ağız tabanı kanserinde peroral rezeksiyon tekniği ve pull-through rezeksiyon tekniğinin onkolojik, fonksiyonel, klinik ve kozmetik sonuçları karşılaştırıldı.Hastalar ve Yöntemler: Ocak 1998 - Şubat 2008 tarihleri arasında primer tedavi olarak peroral ve pull-through rezeksiyon teknikleri uygulanan T1, T2 evre oral dil veya ağız tabanı kanserli 49 hasta 23 kadın, 26 erkek; ort. yaş 54.4 yıl; dağılım 21-87 yıl bu çalışmaya alındı. Çalışma sırasında elde edilen veriler klinik takip, tümör evresi, ameliyat tipi retrospektif olarak, hasta takiplerinden elde edilen veriler nüks, konuşma, yeme-içme fonksiyonları, kozmetik görünüm, hasta memnuniyeti ise prospektif olarak değerlendirildi. Yirmi iki hasta T1, 27 hasta ise T2 olarak evrelendirildi. T1 evresindeki 10 hastaya pull-through rezeksiyon, 12 hastaya ise peroral rezeksiyon yapıldı. T2 evresindeki 16 hastaya pull-through rezeksiyon, 11 hastaya ise peroral rezeksiyon uygulandı. Rezeksiyon teknikleri arasındaki karşılaştırmalar, bağımsız örnekler t-test, tek yönlü ANOVA testi ve ki-kare testi kullanılarak yapıldı.Bulgular: Ameliyat sonrası histopatolojik incelemede, T1, T2erken evreli 49 hastanın 13’ünde %27 servikal lenf nodu metastazı tespit edildi. T2 tümörlerdeki fark nüks açısından istatistiksel olarak anlamlı bulundu p

Anahtar Kelimeler

Peroral rezeksiyon, pull-through rezeksiyon, dil ve ağız tabanı kanseri