0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Review |

Removing the Taboo on the Surgical Violation (Cut-Through) of Cancer ONLINE FIRST

K. Thomas Robbins, MD, FRCSC1; Carol R. Bradford, MD2; Juan P. Rodrigo, MD, PhD3,4; Carlos Suárez, MD, PhD4,5; Remco de Bree, MD, PhD6; Luiz P. Kowalski, MD, PhD7; Alessandra Rinaldo, MD, FRCSEd ad hominem, FRCS(Eng, Ir) ad eundem, FRCS(Glasg)8; Carl E. Silver, MD9,10; Valerie J. Lund, MD, FRCS, FRCSEd, CBE11; Ken-ichi Nibu, MD, PhD12; Alfio Ferlito, MD, DLO, DPath, FRCSEd ad hominem, FRCS(Eng, Glasg, Ir) ad eundem, FDSRCS ad eundem, FHKCORL, FRCPath13
[+] Author Affiliations
1Division of Otolaryngology–Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield
2Department of Otolaryngology–Head and Neck Surgery, University of Michigan Health System, Ann Arbor
3Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain
4Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
5Fundación de Investigación e Innovación Biosanitaria del Principado de Asturias, Oviedo, Spain
6Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands
7Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, Sao Paulo, Brazil
8University of Udine School of Medicine, Udine, Italy
9Department of Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
10Department of Otolaryngology–Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
11Professorial Unit, Ear Institute, University College London, London, United Kingdom
12Department of Otolaryngology–Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
13Coordinator of the International Head and Neck Scientific Group
JAMA Otolaryngol Head Neck Surg. Published online July 28, 2016. doi:10.1001/jamaoto.2016.1826
Text Size: A A A
Published online

Importance  The surgical dictum of en bloc resection without violating cancer tissue has been challenged by novel treatments in head and neck cancer.

Observations  An analysis of treatment outcomes involving piecemeal removal of sinonasal, laryngeal, oropharyngeal, and hypopharyngeal cancer shows that it did not compromise tumor control. The rationale for the evolution toward use of this technique is outlined.

Conclusions and Relevance  While complete resection with clear margins remains a key end point in surgical oncology, we believe it is time to acknowledge that this time-honored dictum of avoiding tumor violation is no longer valid in selected situations.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment
Congratulations
Posted on August 3, 2016
Luiz R. Medina dos Santos, MD, PhD
Oncologic Research Center - Florianopolis - SC - Brazil
Conflict of Interest: None Declared
This is a very important change of paradigm and evolution, that will contribute for treatment of our cancer patients.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

221 Views
0 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Quick Reference

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Quick Reference

brightcove.createExperiences();