New carcinoma research from A. Kreeft and colleagues discussed
2009 JUN 1 - (NewsRx.com) -- "If surgical resection of a tumour results in an unacceptable loss of function, this is defined as 'functional inoperability'. The current survey aims to define the borders of functional inoperability in oral and oropharyngeal carcinoma and evaluate its current use by obtaining opinions from the experts in the field," researchers in Netherlands report. "A web base survey. Dutch head-neck surgeons and radiotherapists. Assessment of functional results after tumour resection in twenty-two statements and five cases. Response on the survey is 93% and the reactions are variable. Reactions vary slightly by the size of the clinic or discipline (radiation oncology versus head and neck surgery). There is agreement about the unacceptable function loss after total glossectomy. There is no absolute consensus about the functional outcome after certain surgical procedures, namely: bilateral maxillectomy, resection of a tonsil and resection of base of tongue carcinoma including removal of the vallecula and epiglottis, and total soft palate resection. Disagreement of operability is also observed for T3 and T4 base of tongue carcinomas based on case descriptions and Magnetic Resonance Images. Assessment of whether one hypoglossal nerve can be preserved is agreed to be a key factor for functional operability. The term functional inoperability appears to be clinically used by Dutch experts in the decision making process in advanced head and neck carcinomas. According to the experts who took part in the survey, primary total glossectomy or sacrificing both hypoglossal nerves is an operation that causes too much and therefore unacceptable function loss. In several case scenarios a consensus over operability could not be reached by the experts. The decision varies per physician, institute and patient," wrote A. Kreeft and colleagues. The researchers concluded: "Functional inoperability is variable and difficult to determine, but it is clinically used and therefore important to bring under attention." Kreeft and colleagues published their study in Clinical Otolaryngology (The surgical dilemma of 'functional inoperability' in oral and oropharyngeal cancer: current consensus on operability with regard to functional results. Clinical Otolaryngology, 2009;34(2):140-146). For additional information, contact A.J.M. Balm, Antoni Van Leeuwenhoek Ziekenhuis, Netherlands Cancer Institute, Dept. of Head & Neck Oncology & Surgery, Plesmanlaan 121, NL-1066 CX Amsterdam, Netherlands. Publisher contact information for the journal Clinical Otolaryngology is: Wiley-Blackwell Publishing, Inc., Commerce Place, 350 Main St., Malden 02148, MA, USA. Keywords: Netherlands, Glossectomy, Laryngology, Maxillectomy, Oncology, Oropharyngeal Cancer, Oropharyngeal Carcinoma, Otolaryngology, Otorhinolaryngology, Surgery, Tongue Cancer, Tongue Carcinoma. This article was prepared by Clinical Oncology Week editors from staff and other reports. Copyright 2009, Clinical Oncology Week via NewsRx.com.
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