A MEDLINE search early in 2015 revealed more than 250,000 papers on head and neck cancer; over 100,000 on oral cancer; and over 60,000 on mouth cancer. Not all publications contain robust evidence. We endeavour to encapsulate the most important of the latest information and advances now employed in practice, in a form comprehensible to healthcare workers, patients and their carers. This series offers the primary care dental team in particular, an overview of the aetiopathogenesis, prevention, diagnosis and multidisciplinary care of mouth cancer, the functional and psychosocial implications, and minimization of the impact on the quality of life of patient and family.
Clinical Relevance: This article offers the dental team an overview of surgery for the treatment of mouth cancer.
Article
If mouth cancer can be diagnosed at an early stage, when the lesions are small, treatment is generally less complicated and more effective. The treatment requires a multispecialty approach co-ordinated among surgeons, radiation oncologists, medical oncologists and others. Since these cancers are uncommon, patients with mouth cancer are usually treated in a specialist hospital under a multidisciplinary team (MDT) where oral squamous cell carcinoma (OSCC) should be staged according to the TNM (Tumour, Node, Metastases) classification (Article 9), since this classification relates well to overall survival rate (ie the earlier the tumour stage, the better the prognosis and the less complicated and mutilating is treatment). This article expands upon Article 9.
Surgery and radiation are the only definitive treatment modalities for both early and locally advanced mouth cancer. Surgical resection, wherein the tumour is completely removed with uninvolved resection margins, is challenging and can involve sacrificing critical structures. Radiation, when used as definitive therapy, circumvents this difficulty, but often produces significant acute and late toxicities (Article 11). Chemotherapy alone is not a curative therapeutic modality, but may improve outcomes when used in conjunction with radiation (chemo-RT) for locally advanced disease (Article 12).
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