Surgical management of oral cancer

Oral cancer remains a challenge and a frustration to the clinician. If treated when the tumor is small and localized, at least 70% of patients can be cured. Results of treatment of early and moderate-sized oral cancers are satisfactory and gratifying with minimal cosmetic and functional disability in contrast to the results following treatment of massive oral cancers. Clearly, the importance of early detection and appropriate treatment while the lesion is still low stage cannot be overemphasized. Alternative treatments, including laser vaporization/resection and photodynamic therapy, are being increasingly investigated and their indications and contraindications defined. Increased knowledge of the intricacies of chemotherapy and immunotherapy and their use as definitive treatment combined with advances in radiation therapy, including hyperfractionated irradiation and use of high-energy particles, may improve the overall outlook. Meanwhile, surgical treatment remains a mainstay in the management of many of these patients. We must emphasize the importance of early diagnosis and in those unfortunate patients with advanced disease further investigated the most efficient and effective combined modality treatment together with expeditious and effective reconstruction. Prevention is the ultimate goal, but as yet our societal motivation and energies are not directed on these lines.