Cytology-based tumor surgery of early-stage oral cavity and oropharyngeal cancer – a monocentric, prospective, randomized, controlled clinical trial (CyCaS)

Introduction Liquid-based swab cytology (LBC) is an established diagnostic tool in prevention, diagnostics and follow-up of cervical cancer but, however, is rarely used in head and neck oncology though these tumors can comparably easy be accessed by the examiner. In the CyCaS study, we investigated the potential use of LBC for a faster and more accurate surgical treatment in head and neck oncology.

Methods 24 patients with cT1-2 squamous cell carcinomas of the oral cavity or oropharynx were included in this study and randomized to two treatment arms: in the control group patients underwent diagnostic panendoscopy with tumor biopsy and in the case of positive histology received tumor resection in a second operation. In the intervention arm we used LBC at the first clinical presentation of the patients and in case of a positive result, one single operation with rapid section histology for confirmation of LBC result and subsequent tumor resection was planned. Time between first clinical presentation and definitive surgical treatment as well as cumulative duration of hospital stay were definded as primary target criteria.

Results Time between clinical diagnosis and definitive surgical treatment (p<0.0001) as well as the cumulative duration of hospital stay (p=0.0002) were significantly shorter in the intervention group compared with the control group. In now case we found discrepancies between LBC, rapid section histology, and histology.

Discussion LBC shows a high diagnostic validity and has the potential to shorten the time between clinical diagnosis and definitive surgical treatment, sparing one general anesthesia for the patients and, thereby, making surgical treatment for more efficient and comfortable.

Publication History

Article published online:
24 May 2022