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JAMA Otolaryngol Head Neck Surg. 2016 Oct 1;142(10):1010-1013. doi: 10.1001/jamaoto.2016.1826.

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

Author information

1
Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield.
2
Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor.
3
Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain4Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain.
4
Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain5Fundación de Investigación e Innovación Biosanitaria del Principado de Asturias, Oviedo, Spain.
5
Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands.
6
Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
7
University of Udine School of Medicine, Udine, Italy.
8
Department of Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York10Department of Otolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York.
9
Professorial Unit, Ear Institute, University College London, London, United Kingdom.
10
Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
11
Coordinator of the International Head and Neck Scientific Group.

Abstract

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in surgical oncology, we believe it is time to acknowledge that this time-honored dictum of avoiding tumor violation is no longer valid in selected situations.

PMID:
27468162
DOI:
10.1001/jamaoto.2016.1826
[Indexed for MEDLINE]

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