Abstract
Background. To reduce the risk of spreading tumor cells by incisional biopsy, we have employed excisional biopsy for early oral squamous cell carcinomas (SCCs). However, whether excisional biopsy should be adopted as a radical treatment for oral carcinomas is still controversial.
Methods. Fifty-eight patients with stage I or II SCC of the oral cavity treated by excisional biopsy were reviewed clinicopathologically to investigate treatment outcome.
Results. Eight of the 58 patients had a recurrence at the primary site and 7 had a secondary lymph node metastasis in the neck; all patients were curable by salvage treatment. We found a significant correlation between local recurrence and margin status and between tumor size and depth invasion. The absence or presence of epithelial dysplasia adjacent to the cancer was also important in predicting local recurrence. Endophytic tumors had a higher rate of neck metastasis than superficial or exophytic tumors (P < 0.001).
Conclusions. Excisional biopsy is an effective and less invasive treatment for small oral SCCs. For superficial tumors that are frequently accompanied by epithelial dysplasia, tumors less than 30mm in size should be excised at a margin of 5 mm or more from the lesion, thereby including the dysplasia. Considering the positive correlation between tumor size and depth of invasion, exophytic tumors less than 20 mm in size can be treated by excisional biopsy alone. As endophytic tumors are highly aggressive and have a high propensity to metastasize to cervical lymph nodes, endophytic tumors less than 15 mm in size are indicated for excisional biopsy.
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Kusukawa, J., Nakamura, Y. & Kameyama, T. Evaluation of excisional biopsy for stage I and IIsquamous cell carcinoma of the oral cavity. Int J Clin Oncol 3, 317–322 (1998). https://doi.org/10.1007/BF02628053
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DOI: https://doi.org/10.1007/BF02628053