Cancer of the oral cavity

Abstract

Cancer of the oral cavity is one of the most common malignancies worldwide. Although early diagnosis is relatively easy, presentation with advanced disease is not uncommon. The standard of care is primary surgical resection with or without postoperative adjuvant therapy. Improvements in surgical techniques combined with the routine use of postoperative radiation or chemoradiation therapy have resulted in improved survival. Successful treatment is predicated on multidisciplinary treatment strategies to maximize oncologic control and minimize impact of therapy on form and function. Prevention of oral cancer requires better education about lifestyle-related risk factors, and improved awareness and tools for early diagnosis.

Keywords: Head and neck cancer; Oral cancer; Oral cavity cancer; Squamous cell carcinoma.

Copyright © 2015 Elsevier Inc. All rights reserved.

Figures

Figure 1

Anatomic sites of the oral cavity From Shah JP, Patel SG, Singh B, et al. Jatin Shah's head and neck surgery and oncology. 4th ed. Philadelphia, PA: Elsevier/Mosby; 2012, 232–244 with permisison.

Figure 2

Incidence of oral cavity cancer among both sexes expressed by level of Age-standardized rate (ASR) in countries of the world (From GLOBOCAN 2012 International Agency for Research on Cancer (http://globocan.iarc.fr/Pages/Map.aspx.))

Figure 3

Cervical lymph node level classification From Shah JP, Patel SG, Singh B, et al. Jatin Shah's head and neck surgery and oncology. 4th ed. Philadelphia, PA: Elsevier/Mosby; 2012, 232–244, with permisison.

Figure 4

Incidence of lymph node metastasis and survival stratified by the thickness of the primary tumor. (From Shah JP, Patel SG, Singh B, et al. Jatin Shah's head and neck surgery and oncology. 4th ed. Philadelphia, PA: Elsevier/Mosby; 2012, 232–244, with permisison.)

Figure 5

Various surgical approaches. A, Peroral. B, Mandibulotomy. C, Lower cheek flap. D, Visor flap. E, Upper cheek flap. (From Shah JP, Patel SG, Singh B, et al. Jatin Shah's head and neck surgery and oncology. 4th ed. Philadelphia, PA: Elsevier/Mosby; 2012, 232–244, with permisison.)

Figure 6

Fibular (left) and radial forearm (right) free flaps are two of the most common flaps used in oral cavity reconstruction after major resections.

Figure 7

Outcomes of treatment of SCCOC in three cohorts treated during different time periods at Memorial Sloan-Kettering Cancer Center (1960–2005). Courtesy of Memorial Sloan-Kettering database, New York, NY.

Figure 8

Clinical stage at presentation is an important predictor of outcome. Courtesy of Memorial Sloan-Kettering database, New York, NY.

Figure 9

Impact of clinically palpable lymph node metastasis on disease-specific survival in SCCOC. Courtesy of Memorial Sloan-Kettering database, New York, NY.