Treatment for oral superficial cancer

Abstract

In 69 patients with superficial oral cancer (32 with tongue cancer, 22 with gingival cancer, 10 with oral floor cancer, and 5 with buccal mucosal cancer), preoperative examinations and treatment were evaluated. The lesion visualization rate was significantly higher for tongue ultrasonography (89.9%) than for CT (21.9%) or MRI (42.4%). Narrow band imaging (NBI) revealed type 3 or 4 abnormal blood vessels (Arima's classification), which are frequently observed in esophageal cancer, in about 80%. The correct diagnosis rate using cytology was 77.9%. However, in 66.7% of false-negative cases, the diagnosis could be corrected based on abnormal blood vessels on NBI images. Lesions identified using NBI were frequently consistent with iodine-unstained areas. In cases showing type 4 abnormal blood vessels on NBI images and the YK-4 histopathological mode of invasion, the possibility of late cervical lymph node metastasis was high. Concerning surgery, excisional biopsy in view of cancer dissemination was frequently performed. Autofluorescence and infrared imaging enhanced cancer lesions, allowing visual identification. Therefore, improvement in diagnosis and clarification of the accurate lesion range by adding special preoperative light observation methods such as NBI to conventional examinations are necessary to accurately perform excisional biopsy, which is frequently used as a treatment for superficial oral cancer.