Surgical resection of oral cancer: en-bloc versus discontinuous approach

Eur Arch Otorhinolaryngol. 2020 Nov;277(11):3127-3135. doi: 10.1007/s00405-020-06016-5. Epub 2020 May 4.

Abstract

Objectives: In the past literature agreed on treating oral carcinomas, using an "en-bloc" resection (EBR) but recently minimally invasive transoral surgery has spread as the preferable treatment for selected cases. This latter technique, which is performed with a discontinuous resection (DR), allows for a satisfactory postoperative quality of life (QoL) maintaining good survival rates.

Materials and methods: In this study, we analyzed data about 147 surgically treated patients with oral cancer involving tongue and floor of the mouth. The sample was divided according to the surgical approach: EBR and DR group which were compared in terms of recurrence, overall survival, disease-free survival, and QoL.

Results: In the DR group, survival analysis showed better results in term of survival, locoregional control, and postoperative anxiety, while the other QoL scores were similar in the two groups.

Conclusion: The more invasive approach does not correlate to a better outcome. In selected cases, DR is an oncologically safe technique; EBR is still a valid option to treat advanced oral cancers.

Keywords: Compartmental surgery; Neck dissection; Oral cancer; Transoral surgery; T–N tract.

MeSH terms

  • Humans
  • Minimally Invasive Surgical Procedures
  • Mouth Neoplasms* / surgery
  • Neoplasm Recurrence, Local / surgery
  • Quality of Life*
  • Treatment Outcome