Cargando…

Diagnostic Value of Lingual Tonsillectomy in Unknown Primary Head and Neck Carcinoma Identification After a Negative Clinical Workup and Positron Emission Tomography-Computed Tomography

OBJECTIVE: Diagnostic rates of unknown primary head and neck carcinoma (UPHNC) using lingual tonsillectomy (LT) are highly variable. This study sought to determine the diagnostic value of LT in UPHNC identification using strict inclusion criteria and definitions to produce a more accurate estimate o...

Descripción completa

Detalles Bibliográficos
Autores principales: Sudoko, Chad K., Polacco, Marc A., Gosselin, Benoit J., Paydarfar, Joseph A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5919999/
https://www.ncbi.nlm.nih.gov/pubmed/29732318
http://dx.doi.org/10.3389/fonc.2018.00118
_version_ 1783317742600847360
author Sudoko, Chad K.
Polacco, Marc A.
Gosselin, Benoit J.
Paydarfar, Joseph A.
author_facet Sudoko, Chad K.
Polacco, Marc A.
Gosselin, Benoit J.
Paydarfar, Joseph A.
author_sort Sudoko, Chad K.
collection PubMed
description OBJECTIVE: Diagnostic rates of unknown primary head and neck carcinoma (UPHNC) using lingual tonsillectomy (LT) are highly variable. This study sought to determine the diagnostic value of LT in UPHNC identification using strict inclusion criteria and definitions to produce a more accurate estimate of diagnosis rate. METHODS: In this retrospective chart review, records of patients who underwent LT for UPHNC were reviewed. Inclusion criteria included absence of suspicious findings on physical exam and positron emission tomography-computed tomography as well as negative biopsies after panendoscopy and palatine tonsillectomy. Following inclusion criteria, 16 patients were reviewed. A systematic literature review on LT for the workup of CUP was also performed. RESULTS: LT was performed using transoral robotic surgery (TORS), transoral laser microsurgery (TLM), or transoral microsurgery with cautery (TMC). Following LT, primary tumor was identified in 4 patients out of 16. Detection rate by technique was 1/6, 2/7, and 1/3 for TORS, TLM, and TMC respectively. Postoperative bleeding occurred in three patients (19%); however, this was not related to the LT. Following literature review, 12 studies were identified; however, only 3 had enough data to compare against. All three studies had a cohort with suspicious findings on clinical exam. A total of 34 patients had a negative workup, with no suspicious findings on clinical exam and subsequently received an LT. CONCLUSION: This study suggests that LT should be considered initially in the diagnostic algorithm for UPHNC. This study can increase the patient size in this cohort by approximately 47%.
format Online
Article
Text
id pubmed-5919999
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-59199992018-05-04 Diagnostic Value of Lingual Tonsillectomy in Unknown Primary Head and Neck Carcinoma Identification After a Negative Clinical Workup and Positron Emission Tomography-Computed Tomography Sudoko, Chad K. Polacco, Marc A. Gosselin, Benoit J. Paydarfar, Joseph A. Front Oncol Oncology OBJECTIVE: Diagnostic rates of unknown primary head and neck carcinoma (UPHNC) using lingual tonsillectomy (LT) are highly variable. This study sought to determine the diagnostic value of LT in UPHNC identification using strict inclusion criteria and definitions to produce a more accurate estimate of diagnosis rate. METHODS: In this retrospective chart review, records of patients who underwent LT for UPHNC were reviewed. Inclusion criteria included absence of suspicious findings on physical exam and positron emission tomography-computed tomography as well as negative biopsies after panendoscopy and palatine tonsillectomy. Following inclusion criteria, 16 patients were reviewed. A systematic literature review on LT for the workup of CUP was also performed. RESULTS: LT was performed using transoral robotic surgery (TORS), transoral laser microsurgery (TLM), or transoral microsurgery with cautery (TMC). Following LT, primary tumor was identified in 4 patients out of 16. Detection rate by technique was 1/6, 2/7, and 1/3 for TORS, TLM, and TMC respectively. Postoperative bleeding occurred in three patients (19%); however, this was not related to the LT. Following literature review, 12 studies were identified; however, only 3 had enough data to compare against. All three studies had a cohort with suspicious findings on clinical exam. A total of 34 patients had a negative workup, with no suspicious findings on clinical exam and subsequently received an LT. CONCLUSION: This study suggests that LT should be considered initially in the diagnostic algorithm for UPHNC. This study can increase the patient size in this cohort by approximately 47%. Frontiers Media S.A. 2018-04-20 /pmc/articles/PMC5919999/ /pubmed/29732318 http://dx.doi.org/10.3389/fonc.2018.00118 Text en Copyright © 2018 Sudoko, Polacco, Gosselin and Paydarfar. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Sudoko, Chad K.
Polacco, Marc A.
Gosselin, Benoit J.
Paydarfar, Joseph A.
Diagnostic Value of Lingual Tonsillectomy in Unknown Primary Head and Neck Carcinoma Identification After a Negative Clinical Workup and Positron Emission Tomography-Computed Tomography
title Diagnostic Value of Lingual Tonsillectomy in Unknown Primary Head and Neck Carcinoma Identification After a Negative Clinical Workup and Positron Emission Tomography-Computed Tomography
title_full Diagnostic Value of Lingual Tonsillectomy in Unknown Primary Head and Neck Carcinoma Identification After a Negative Clinical Workup and Positron Emission Tomography-Computed Tomography
title_fullStr Diagnostic Value of Lingual Tonsillectomy in Unknown Primary Head and Neck Carcinoma Identification After a Negative Clinical Workup and Positron Emission Tomography-Computed Tomography
title_full_unstemmed Diagnostic Value of Lingual Tonsillectomy in Unknown Primary Head and Neck Carcinoma Identification After a Negative Clinical Workup and Positron Emission Tomography-Computed Tomography
title_short Diagnostic Value of Lingual Tonsillectomy in Unknown Primary Head and Neck Carcinoma Identification After a Negative Clinical Workup and Positron Emission Tomography-Computed Tomography
title_sort diagnostic value of lingual tonsillectomy in unknown primary head and neck carcinoma identification after a negative clinical workup and positron emission tomography-computed tomography
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5919999/
https://www.ncbi.nlm.nih.gov/pubmed/29732318
http://dx.doi.org/10.3389/fonc.2018.00118
work_keys_str_mv AT sudokochadk diagnosticvalueoflingualtonsillectomyinunknownprimaryheadandneckcarcinomaidentificationafteranegativeclinicalworkupandpositronemissiontomographycomputedtomography
AT polaccomarca diagnosticvalueoflingualtonsillectomyinunknownprimaryheadandneckcarcinomaidentificationafteranegativeclinicalworkupandpositronemissiontomographycomputedtomography
AT gosselinbenoitj diagnosticvalueoflingualtonsillectomyinunknownprimaryheadandneckcarcinomaidentificationafteranegativeclinicalworkupandpositronemissiontomographycomputedtomography
AT paydarfarjosepha diagnosticvalueoflingualtonsillectomyinunknownprimaryheadandneckcarcinomaidentificationafteranegativeclinicalworkupandpositronemissiontomographycomputedtomography