Transoral tongue base mucosectomy for the identification of the primary site in the work-up of cancers of unknown origin: systematic review and metaanalysis

Saadia  Farooq; Sunil  Khandavilli; Janine Dretzke; David Moore; Paul Nankivell; Neil Sharma; John R.  de Almeida; Stuart Winter; Christian Simon; Vinidh Paleri; Mrganke  De; Somiah  Siddiq; Christopher  Holsinger; Robert L.  Ferris; Hisham Mehanna

doi:10.1016/j.oraloncology.2019.02.018

Transoral tongue base mucosectomy for the identification of the primary site in the work-up of cancers of unknown origin: systematic review and metaanalysis

Saadia Farooq, Sunil Khandavilli, Janine Dretzke, David Moore, Paul Nankivell, Neil Sharma, John R. de Almeida, Stuart Winter, Christian Simon, Vinidh Paleri, Mrganke De, Somiah Siddiq, Christopher Holsinger, Robert L. Ferris, Hisham Mehanna

Research output: Contribution to journal › Review article › peer-review

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Abstract

Background: The use of transoral robotic surgery (TORS) and laser microsurgery (TLM) in the diagnosis and identification of the site of the unknown primary has become increasingly common. This systematic review and meta-analysis aims to assess the use and efficacy of TORS and TLM for this indication.

Method: Systematic review and meta-analysis of studies employing TORS or TLM in diagnosis of the unknown primary tumor site in patients with cervical nodal metastases of squamous cell origin. MEDLINE, EMBASE and CINHAL were searched from inception to July 2018 for all studies that used TORS and or TLM in identifying the unknown primary.

Results: 251 studies were identified, of which 21 were eligible for inclusion. The primary tumour was identified by TORS/TLM in 78% of patients (433 out of 556). Tongue base mucosectomy (TBM) identified the primary in 222 of 427 cases (53%). In patients with negative physical examination, diagnostic imaging and PETCT, TBM identified the primary in 64% (95% CI 50, 79) cases. In patients who had negative CT/MRI imaging, negative PETCT and negative EUA and tonsillectomy, TBM identified a tongue base primary in 78% (95% CI 41, 92) cases. Haemorrhage, the commonest complication, was reported in 4.9% cases. Mean length of stay varied between 1.4
and 6.3 days.

Conclusion: Tongue base mucosectomy, performed by TORS or TLM, is highly efficacious in identifying the unknown primary in the head and neck region.

Original language	English
Pages (from-to)	97-106
Number of pages	10
Journal	Oral Oncology
Volume	91
Early online date	6 Mar 2019
DOIs	https://doi.org/10.1016/j.oraloncology.2019.02.018
Publication status	Published - 1 Apr 2019

Keywords

Cancer of unknown origin
Head and neck cancer
Microsurgery
Tongue base mucosectomy
Trans oral LASER
Trans oral robotic surgery
Unknown primary

ASJC Scopus subject areas

Oral Surgery
Oncology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

Farooq, S., Khandavilli, S., Dretzke, J., Moore, D., Nankivell, P., Sharma, N., de Almeida, J. R., Winter, S., Simon, C., Paleri, V., De, M., Siddiq, S., Holsinger, C., Ferris, R. L., & Mehanna, H. (2019). Transoral tongue base mucosectomy for the identification of the primary site in the work-up of cancers of unknown origin: systematic review and metaanalysis. Oral Oncology, 91, 97-106. https://doi.org/10.1016/j.oraloncology.2019.02.018

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title = "Transoral tongue base mucosectomy for the identification of the primary site in the work-up of cancers of unknown origin: systematic review and metaanalysis",

abstract = "Background: The use of transoral robotic surgery (TORS) and laser microsurgery (TLM) in the diagnosis and identification of the site of the unknown primary has become increasingly common. This systematic review and meta-analysis aims to assess the use and efficacy of TORS and TLM for this indication.Method: Systematic review and meta-analysis of studies employing TORS or TLM in diagnosis of the unknown primary tumor site in patients with cervical nodal metastases of squamous cell origin. MEDLINE, EMBASE and CINHAL were searched from inception to July 2018 for all studies that used TORS and or TLM in identifying the unknown primary.Results: 251 studies were identified, of which 21 were eligible for inclusion. The primary tumour was identified by TORS/TLM in 78% of patients (433 out of 556). Tongue base mucosectomy (TBM) identified the primary in 222 of 427 cases (53%). In patients with negative physical examination, diagnostic imaging and PETCT, TBM identified the primary in 64% (95% CI 50, 79) cases. In patients who had negative CT/MRI imaging, negative PETCT and negative EUA and tonsillectomy, TBM identified a tongue base primary in 78% (95% CI 41, 92) cases. Haemorrhage, the commonest complication, was reported in 4.9% cases. Mean length of stay varied between 1.4and 6.3 days.Conclusion: Tongue base mucosectomy, performed by TORS or TLM, is highly efficacious in identifying the unknown primary in the head and neck region.",

keywords = "Cancer of unknown origin, Head and neck cancer, Microsurgery, Tongue base mucosectomy, Trans oral LASER, Trans oral robotic surgery, Unknown primary",

author = "Saadia Farooq and Sunil Khandavilli and Janine Dretzke and David Moore and Paul Nankivell and Neil Sharma and {de Almeida}, {John R.} and Stuart Winter and Christian Simon and Vinidh Paleri and Mrganke De and Somiah Siddiq and Christopher Holsinger and Ferris, {Robert L.} and Hisham Mehanna",

year = "2019",

month = apr,

day = "1",

doi = "10.1016/j.oraloncology.2019.02.018",

language = "English",

volume = "91",

pages = "97--106",

journal = "Oral Oncology",

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publisher = "Elsevier",

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Farooq, S, Khandavilli, S, Dretzke, J , Moore, D , Nankivell, P , Sharma, N, de Almeida, JR, Winter, S, Simon, C, Paleri, V, De, M, Siddiq, S, Holsinger, C, Ferris, RL & Mehanna, H 2019, 'Transoral tongue base mucosectomy for the identification of the primary site in the work-up of cancers of unknown origin: systematic review and metaanalysis', Oral Oncology, vol. 91, pp. 97-106. https://doi.org/10.1016/j.oraloncology.2019.02.018

TY - JOUR

T1 - Transoral tongue base mucosectomy for the identification of the primary site in the work-up of cancers of unknown origin

T2 - systematic review and metaanalysis

AU - Farooq, Saadia

AU - Khandavilli, Sunil

AU - Dretzke, Janine

AU - Moore, David

AU - Nankivell, Paul

AU - Sharma, Neil

AU - de Almeida, John R.

AU - Winter, Stuart

AU - Simon, Christian

AU - Paleri, Vinidh

AU - De, Mrganke

AU - Siddiq, Somiah

AU - Holsinger, Christopher

AU - Ferris, Robert L.

AU - Mehanna, Hisham

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Background: The use of transoral robotic surgery (TORS) and laser microsurgery (TLM) in the diagnosis and identification of the site of the unknown primary has become increasingly common. This systematic review and meta-analysis aims to assess the use and efficacy of TORS and TLM for this indication.Method: Systematic review and meta-analysis of studies employing TORS or TLM in diagnosis of the unknown primary tumor site in patients with cervical nodal metastases of squamous cell origin. MEDLINE, EMBASE and CINHAL were searched from inception to July 2018 for all studies that used TORS and or TLM in identifying the unknown primary.Results: 251 studies were identified, of which 21 were eligible for inclusion. The primary tumour was identified by TORS/TLM in 78% of patients (433 out of 556). Tongue base mucosectomy (TBM) identified the primary in 222 of 427 cases (53%). In patients with negative physical examination, diagnostic imaging and PETCT, TBM identified the primary in 64% (95% CI 50, 79) cases. In patients who had negative CT/MRI imaging, negative PETCT and negative EUA and tonsillectomy, TBM identified a tongue base primary in 78% (95% CI 41, 92) cases. Haemorrhage, the commonest complication, was reported in 4.9% cases. Mean length of stay varied between 1.4and 6.3 days.Conclusion: Tongue base mucosectomy, performed by TORS or TLM, is highly efficacious in identifying the unknown primary in the head and neck region.

AB - Background: The use of transoral robotic surgery (TORS) and laser microsurgery (TLM) in the diagnosis and identification of the site of the unknown primary has become increasingly common. This systematic review and meta-analysis aims to assess the use and efficacy of TORS and TLM for this indication.Method: Systematic review and meta-analysis of studies employing TORS or TLM in diagnosis of the unknown primary tumor site in patients with cervical nodal metastases of squamous cell origin. MEDLINE, EMBASE and CINHAL were searched from inception to July 2018 for all studies that used TORS and or TLM in identifying the unknown primary.Results: 251 studies were identified, of which 21 were eligible for inclusion. The primary tumour was identified by TORS/TLM in 78% of patients (433 out of 556). Tongue base mucosectomy (TBM) identified the primary in 222 of 427 cases (53%). In patients with negative physical examination, diagnostic imaging and PETCT, TBM identified the primary in 64% (95% CI 50, 79) cases. In patients who had negative CT/MRI imaging, negative PETCT and negative EUA and tonsillectomy, TBM identified a tongue base primary in 78% (95% CI 41, 92) cases. Haemorrhage, the commonest complication, was reported in 4.9% cases. Mean length of stay varied between 1.4and 6.3 days.Conclusion: Tongue base mucosectomy, performed by TORS or TLM, is highly efficacious in identifying the unknown primary in the head and neck region.

KW - Cancer of unknown origin

KW - Head and neck cancer

KW - Microsurgery

KW - Tongue base mucosectomy

KW - Trans oral LASER

KW - Trans oral robotic surgery

KW - Unknown primary

UR - http://www.scopus.com/inward/record.url?scp=85062390747&partnerID=8YFLogxK

U2 - 10.1016/j.oraloncology.2019.02.018

DO - 10.1016/j.oraloncology.2019.02.018

M3 - Review article

SN - 1368-8375

VL - 91

SP - 97

EP - 106

JO - Oral Oncology

JF - Oral Oncology

ER -

Transoral tongue base mucosectomy for the identification of the primary site in the work-up of cancers of unknown origin: systematic review and metaanalysis

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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