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Abstract：
Early oral cancer is preferably treated by surgery. Its complete removal is essential for locoregional control and disease-free survival. Inadequate resection margins require adjuvant therapy such as re-resection or (chemo)radiation, that causes extra morbidity and oral discomfort. Intraoral ultrasonography (US) is reported to be of value in determining tumor thickness. Intraoperative visualization of the tumor may facilitate the resection and ensure adequate surgical margins. Furthermore, accurate prediction of tumor thickness could help determine the treatment strategy of the clinically node-negative neck, as thickness and depth of invasion are predictors of cervical metastasis as well as prognosticators of survival. The 8th edition of the American Joint Committee on Cancer staging system for oral squamous cell carcinoma has included depth of invasion as parameter for cT-stage. The aim of this review is to analyze the accuracy of intraoral US in determining tumor thickness in oral cancer. A systematic search was conducted, and the quality of the included papers was assessed using the QUADAS-2 tool for diagnostic accuracy studies. Subsequently, a meta-analysis was performed on the available individual participant data of 240 patients. Most of the twelve included studies focused on T1-2 tongue cancer (n = 129). Meta-analysis showed a high correlation in tumor thickness within this subgroup as measured by intraoral US and histopathology (r = 0.82, p < .001), with minor overestimation of 0.5 mm on US. It is concluded that intraoral US is very accurate in determining tumor thickness in early oral tongue cancer.
摘要：
早期口腔癌优选通过手术治疗。完全清除它对于局部控制和无病生存至关重要。切除边缘不足需要辅助治疗，如再次切除或（化学）放疗，导致额外的发病率和口腔不适。据报道，口内超声检查（US）在确定肿瘤厚度方面具有重要价值。肿瘤的术中可视化可以促进切除并确保足够的手术切缘。此外，准确预测肿瘤厚度有助于确定临床淋巴结阴性颈部的治疗策略，因为浸润的厚度和深度是宫颈转移的预测因子，也是生存的预测因子。美国癌症联合委员会第8版口腔鳞状细胞癌分期系统已将浸润深度作为cT分期的参数。这篇综述的目的是分析口腔内超声在确定口腔癌肿瘤厚度方面的准确性。进行了系统的搜索，纳入论文的质量使用QUADAS-2工具进行诊断准确性研究.随后，我们对240例患者的现有个体数据进行了荟萃分析.12项纳入的研究大多集中在T1-2舌癌(n=129)。荟萃分析显示，通过口内超声和组织病理学测量，该亚组中的肿瘤厚度高度相关（r=0.82，p<.001），在美国轻微高估0.5毫米。结论口内超声在确定早期口腔舌癌的肿瘤厚度方面非常准确。
