ENT & Audiology, Norfolk & Norwich University Hospitals NHS Trust, Norwich, UK.
Anaesthesia, Norfolk & Norwich University Hospitals NHS Trust, Norwich, UK.
J Laryngol Otol. 2023 Apr;137(4):438-441. doi: 10.1017/S0022215122001311. Epub 2022 Jun 8.
Tongue base mucosectomy identified cancer in 78 per cent of cancers of unknown primary in a recent meta-analysis. The carbon dioxide laser is an alternative technique if there is no access to a robot. This study aimed to describe the steps for undertaking tongue base mucosectomy using the carbon dioxide laser and its diagnostic utility in cancers of unknown primary.
This was a prospective feasibility study utilising carbon dioxide laser for tongue base mucosectomy in cancers of unknown primary. Data collected included demographic data and p16 status.
There were 14 cancers of unknown primary with 86 per cent p16 positivity on immunohistochemistry. Laser tongue base mucosectomy alone identified the cancer primary in 7 of 12 (58 per cent) cancers of unknown primary among p16 positive tumours and 0 of 2 (0 per cent) among p16 negative tumours. Combining bilateral tonsillectomy with laser tongue base mucosectomy resulted in identification of the primary cancer in 8 of 12 (67 per cent) p16 positive tumours.
In centres without a robot, tongue base mucosectomy using the carbon dioxide laser is a viable alternative, especially in combination with bilateral tonsillectomy in p16 positive cases.
在最近的一项荟萃分析中，舌根黏膜切除术在 78%的不明原发灶癌症中发现了癌症。如果无法使用机器人，则二氧化碳激光是一种替代技术。本研究旨在描述使用二氧化碳激光进行舌根黏膜切除术的步骤及其在不明原发灶癌症中的诊断效用。
这是一项前瞻性可行性研究，在不明原发灶癌症中使用二氧化碳激光进行舌根黏膜切除术。收集的数据包括人口统计学数据和 p16 状态。
有 14 例不明原发灶癌症，其中 86%的免疫组织化学 p16 阳性。单独的激光舌根黏膜切除术在 12 例 p16 阳性肿瘤中的 7 例（58%）和 2 例 p16 阴性肿瘤中的 0 例（0%）中确定了癌症的原发灶。双侧扁桃体切除术联合激光舌根黏膜切除术可使 12 例 p16 阳性肿瘤中的 8 例（67%）确定原发癌。
在没有机器人的中心，使用二氧化碳激光的舌根黏膜切除术是一种可行的替代方法，尤其是在 p16 阳性病例中结合双侧扁桃体切除术。
