[An evaluation of excisional biopsy for tongue carcinoma].

Nihon Gan Chiryo Gakkai shi Pub Date : 1990-11-20
K Hirano, S Ebihara, I Ono, T Yoshizumi, W Ohyama, M Saikawa, Y Ohta, R Hayashi, K Mukai
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Abstract

An evaluation of excisional biopsy for tongue carcinoma (T1, T2) as a surgical treatment was performed. Forty-seven patients who received excisional biopsy among 394 patients with tongue carcinoma (T1, T2) treated in National Cancer Center Hospital during 24 years were examined. These patients were divided into following three groups: group a) patients treated with excisional biopsy only, group b) those treated with excisional biopsy and cryosurgery, group c) those treated with excisional biopsy and radiotherapy. We examined local control rate of these groups, degree of differentiation in histopathological examination, and median cancer free surgical margin. From these we obtained following results: 1) There was no significance in local control rate among these three groups (group a 77%, group b 84%, group c 45%) 2) There were no local recurrences in the patients with cancer free margin of 5 mm or more except when the histopathology showed perineural invasion, lymphatic vessel invasion, and/or deep invasion to the muscle. 3) Even if we had cancer positive surgical margin with excisional biopsy, we could obtain high local control rate (75%) with additional cryosurgery. We conclude that excisional biopsy for tongue carcinoma (T1, T2) is a good method for primary therapy.

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舌癌切除活检的评价。
评估舌癌切除活检(T1, T2)作为手术治疗的效果。本文分析了24年来国立肿瘤中心医院收治的394例舌癌(T1、T2)患者中47例行切除活检的病例。将患者分为三组:a)单纯切除活检组,b)切除活检+冷冻手术组,c)切除活检+放疗组。我们检查了这些组的局部控制率、组织病理学检查的分化程度和中位无癌手术切缘。结果表明:1)三组间局部控制率差异无统计学意义(a组77%,b组84%,c组45%)2)无癌缘5mm及以上患者除组织病理学表现为神经周围浸润、淋巴管浸润、肌肉深部浸润外,均无局部复发。3)即使切除活检的手术切缘癌阳性,我们也可以通过额外的冷冻手术获得较高的局部控制率(75%)。我们认为舌癌(T1, T2)的切除活检是一种良好的初级治疗方法。
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