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Oral Cancer
Early diagnostic and
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Treatment
Professor Igor Reshetov
P.A.Hertzen Cancer Research Institute
Moscow
www.headneckonco.ru
Epidemiology of
SCCHN
Squamous cell carcinoma of the
head and neck (SCCHN): 98 000
new cases in Europe annually
SCCHN: mortality in
Europe is 43 000 annually
Worldwide annual
incidence of SCCHN:
485 000 new patients; 261
000 deaths
SCCHN accounts
for 6% of all
malignancies
GLOBOCAN 2002 (http://www-dep.iar.fr)
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J.Shah 2012
Etiology factors in oral cancer
Reasons for
early diagnostic
oral cancer
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J.Shah 2012
Pathogeneses oral cancer and
depends T(tumor)) and N
(metastases) factors
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J.Shah 2012
Rate of survival in depend
with T(tumor) factor
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J.Shah 2012
Survival in depend with
N(metastases) factor
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Sloan-Kettering Cancer Center 2012
Survival in depend
with location of
tumor
Methods of early
diagnostic oral cancer
Possibilities ultra=scope in
compare with light endoscopy
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Different view in oral
mucosa
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White light endoscopy and fluoroscopy –
correct vision margins and area
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Mechanism of spectroscope oral mucosa
Confocal laser microscopy
New method of morphological diagnostic in
vivo tumors on skin and mucosa
sensitivity - 88,5%
Specifity – 97,6%
Strategy of treatment –
innovation new
technologies
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Sloan-Kettering Cancer Center
Rate of survival in
depend with
possibilities of
combine treatment
Molecularly targeted
agents in oncology
Breast cancer
(early, metastatic)
Bev, TZB, LAP..
Colo rectal ca
(metastatic)
Bev, CET, PAN
Renal cancer
(metastatic)
Bev, sunitynib, ewerolimus
Sorafenib, TEMSR,
NSCLC
(metastatic)
Bevacizumab
HCC
(advanced)
sorafenib
GIST
Imatinib
Gastric cancer
(metastatic)
TZB
Pancreatic ca
(metastatic)
erlotinib
Brain tumors
(advanced)
Bev
HNSCC
(advanced)
CET
New agents

EGFR Inhibitors




Gefitinib (TKI)- NSCLC
Erlotinib (TKI)- NSCLC,
pancreatic ca
Cetuximab (MAB)- colorectal
ca, head and neck
squamous cell ca, NSCLC
Panitumumab (MAB)colorectal ca
EGFR Receptor
Ryc. Materiały informacyjne Amgen
Technologies in surgical oncology
Intraoperative radiotherapy
Electrochemical lysis
Definition of sentry lymph node
Photodynamic diagnostic and therapy
Clinic example P-t С. 16 year.
Diagnosis : recurrent pappilomas of larynx
Befor treatment
with displasia 3 grade
Splan cell pappilomas / ВПЧ 6 + 11 типы
Combine treatment
Electroresection
Nd:YAG laser
PDD (5Аla)
Result – 5 years full remission
1 year after.
Robotic-assisted surgery
Da Vinci robot–assisted endocrine surgery: Novel
applications in otolaryngology
Neil Tanna, MD, Arjun S. Joshi, MD, Robert S. Glade, MD,
Daniel Zalkind, BS, and Nader Sadeghi, MD, Washington, DC
Otolaryngology–Head and Neck Surgery (2006) 135, 633-635
TORS access
Transoral robotic surgery
Neil G. Hockstein, MD,a,b Bert W. O’Malley, Jr, MDb
Operative Techniques in Otolaryngology (2008) 19, 67-71
Advantages of TORS
Trans cervical surgery with
trocards of robotic laparoscopic
surgery
Better orientation and
exposition of the tools :
Possible surgery of the
hypopharynx
Aim – total
survival more
90 %
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Thank your Attention
www.headneckonco.ru