SURGICAL TREATMENT OF ORAL CANCER

Oralni karcinom spada u manje učestale tumore u Europi i SAD-u s incidencijom do 10%, međutim, za razliku od ostalih malignoma humane onkologije, njegova progresija je veoma očita, kozmetički deformirajuća i funkcionalno i psihološki uznemiravajuća. Cilj ovog rada je utvrditi učestalost pacijenata s oralnim i orofaringealnim karcinomom hospitaliziranih na Klinici za maksilofacijalnu kirurgiju Kliničkog bolničkog centra Rijeka u periodu od 2013-2017. godine s posebnim naglaskom na „mikro lokalizaciju“ malignoma unutar usne šupljine i stadij bolesti u kojemu se pacijenti jave, odabir kirurškog liječenja, disekcije i rekonstrukcije za iste. U ovo istraživanje bili su uključeni pacijenti koji su u navedenom periodu hospitalizirani na Klinici za maksilofacijalnu kirurgiju u Kliničkom bolničkom centru Rijeka pod dijagnozom oralni i orofaringealni karcinom, izuzev karcinoma usnica, i podvrgnuti kirurškom liječenju. Obrađeno je 117 pacijenata na temelju slijedećih podataka: dob, spol, konzumacija supstanci poput alkohola i cigareta, komorbiditeti, lokalizacija karcinoma, TNM stadij, vrsta operativnog zahvata, vrsta disekcije te vrsta rekonstrukcije uz potrebu za traheostomom. Rezultati ovog istraživanja pokazuju da od oralnog karcinoma češće oboljevaju muškarci (74%), a najveća incidencija pojavnosti za oba spola je u dobi od 55 do 74 godine (67.3%). Dvije trećine oboljelih svakodnevno puši cigarete. Najčešća lokalizacija oralnog karcinoma bile su prednje 2/3 jezika (30.7%), a najviše pacijenata hospitalizirano je s T2 lezijom (76%) i preko polovica pacijenata bilo je bez palpabilnih limfnih čvorova (56.4%). Najviše pacijenata javljalo se u II stadiju (30.8%), a „commando bez resekcije mandibule“ bila je naučestalija operacija (28.2%). Disekcija vrata se učinila kod 73.5% pacijenata, dok je radikalna disekcija vrata najučestalija učinjena vrsta disekcije (58%).Oral carcinoma is not so common in the European and the USA population with the incidence of up to 10%. However, differing from the other malignomas of human oncology, its progression and cosmetic defect are very apparent, being functionally and psychologically disturbing. The aim of this study is to determine the frequency of oral and oropharyngeal carcinoma among the patients hospitalised at the Clinical Medical Center Rijeka during the period of 2013-2017 with highlighting the „miqro localization“ of the oral cavity malignoma and the stage that patients are being presented, choice of surgical treatment, choice of appropriate neck dissection and the following reconstruction. Patients that were a part of this study where the ones being hospitalised at the Department of Maxilloafacial surgery at the Clinical Medical Center Rijeka in the period mentioned above under the diagnosis of oral and oropharingeal carcinoma, excluding the carcinoma of the lip, and who went through with the surgical treatment. There were 117 patients being proccesed for the following informations: age, sex, consumption of alcohol and smoking cigarettes, systemic disorder, localization of the carcinoma, TNM stage, choice of the surgical treatment, type of neck dissection, reconstruction and the need for a tracheostoma being performed. Results of this study are showing that men are the ones who are more often being presented with the oral carcinoma (74%) and the biggest incidence for both sexes is from 55 to 74 years of age. (67.3%) Two thirds of the patients smoke on a daily basis. The most common sife of the oral carcinoma was the front of the tongue (30.7%) and is called an oral tongue cancer. Most patients were being presented with T2 lesion (76%) and over half of the patients were being presented without palpable cervical lymph nodes (56.4%). Most patients being presented were in the stage II (30.8%) and the „commando operation without mandible management“ was the moost common procedure taking place (28.2%). Neck dissection occured in 73.5% of the patients while radical neck dissection was the most common type of dissection being performed (58%)