Department of Otolaryngology-Head and Neck Surgery, University of California at Davis, Resident, Sacramento, California.
Department of Otolaryngology-Head and Neck Surgery, Washington University, Assistant Professor, St. Louis, Missouri.
Head Neck. 2019 Mar;41(3):799-812. doi: 10.1002/hed.25423. Epub 2019 Jan 21.
The diagnosis and management of oral cavity cancer has been well described in developed countries, however, in regions with fewer medical resources, alternative methods may need to be used. We outline an approach to evaluation and treatment of oral cavity cancer in low-resource areas.
Reviews of the Cochrane and Pubmed databases were performed and literature compiled. Expert opinions from the American and African Head and Neck Societies were also provided.
Treatment guidelines for managing oral cavity cancer in low-resource regions are outlined and the level of supporting evidence is defined.
Successful treatment typically involves the use of upfront surgical resection of the primary lesion and any involved or at-risk cervical lymph node basins, with adjuvant therapy based on the final pathology findings. In situations where services such as adjuvant therapy and/or appropriate reconstruction are not available, alternative approaches to treatment may be needed.
在发达国家,口腔癌的诊断和治疗已有详细描述,然而在医疗资源较少的地区,可能需要使用替代方法。我们概述了在资源匮乏地区评估和治疗口腔癌的方法。
对 Cochrane 和 Pubmed 数据库进行了回顾,并对文献进行了汇编。还提供了来自美国和非洲头颈部协会的专家意见。
概述了资源匮乏地区管理口腔癌的治疗指南,并定义了支持证据的水平。
成功的治疗通常需要采用初始手术切除原发性病变和任何受累或有风险的颈部淋巴结盆,根据最终的病理发现进行辅助治疗。在没有辅助治疗和/或适当重建等服务的情况下,可能需要采用替代治疗方法。