Cancerisation within the oral cavity: The use of ‘field mapping biopsies’ in clinical management

Summary Field cancerisation within the oral cavity risks multiple primary tumour development. Whilst multi-focal disease may ultimately affect up to 24% of oral cancer patients, a particular management problem is encountered with those patients presenting with pan-oral dysplasia. In an attempt to ch...

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Published inOral oncology Vol. 43; no. 1; pp. 20 - 26
Main Authors Thomson, P.J, Hamadah, O
Format Journal Article
LanguageEnglish
Published Oxford Elsevier Ltd 01.01.2007
Elsevier
Subjects
Adolescent
Adult
Aged
Biological and medical sciences
Biopsy
Carcinoma, Squamous Cell - prevention & control
Cell Transformation, Neoplastic
Child
Erythroplasia - pathology
Female
Field change
Hematology, Oncology and Palliative Medicine
Humans
Laser surgery
Leukoplakia, Oral - pathology
Male
Medical sciences
Middle Aged
Mouth Neoplasms - pathology
Mouth Neoplasms - prevention & control
Oral precancer
Otolaryngology
Otorhinolaryngology. Stomatology
Precancerous Conditions - pathology
Prospective Studies
Tumors
Oral precancer
Laser surgery
Field change
Cartography
Premalignant lesion
Stomatology
Use
ENT
Oral cavity
Cancerology
Clinical management
Treatment
Biopsy
Surgery
Laser
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Summary:Summary Field cancerisation within the oral cavity risks multiple primary tumour development. Whilst multi-focal disease may ultimately affect up to 24% of oral cancer patients, a particular management problem is encountered with those patients presenting with pan-oral dysplasia. In an attempt to characterise the extent of dysplasia and to quantify the risk of malignant change, examination under anaesthesia (EUA) and multiple, ‘field mapping biopsies’ were carried out for 16 consecutive patients presenting with pan-oral disease. Seventy lesions, predominantly homogenous leukoplakias, were biopsied primarily showing hyperkeratosis or mild dysplasia histologically. More significant dysplasia was seen to affect the faucial pillars, floor of mouth and ventral tongue. Interventional CO2 laser surgery was used to excise 11 severely dysplastic lesions in six patients. Field mapping appears effective in the initial identification and treatment of the most significant areas of dysplasia in patients with multi-focal precancer. Longitudinal, multi-centre trials are now required.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:1368-8375
1879-0593
DOI:10.1016/j.oraloncology.2005.12.019