ear, nose, and throat disorders
Oral Squamous Cell Carcinoma
Treatment of Oral Squamous Cell Carcinoma
Surgery, with postoperative radiation or chemoradiation as needed For most oral cavity cancers, surgery is the initial treatment of choice. Radiation or chemoradiation is added postoperatively if disease is more advanced or has high-risk histologic features. (See also the National Cancer Institute’s summaryLip and Oral Cavity Cancer Treatment.) Selective neck dissection is indicated if the risk of nodal disease exceeds 15 to 20%. Although there is no firm consensus, neck dissections are typically done for any lesion with a depth of invasion > about 3.5 mm. Routine surgical reconstruction is the key to reducing postoperative oral disabilities; procedures range from local tissue flaps to free tissue transfers. Speech and swallowing therapy may be required after significant resections. Radiation therapy is an alternative treatment. Chemotherapy is not used routinely as primary therapy but is recommended as adjuvant therapy along with radiation in patients with advanced nodal disease. Treatment of squamous cell carcinoma of the lip is surgical excision with reconstruction to maximize postoperative function. When large areas of the lip exhibit premalignant change, the lip can be surgically shaved, or a laser can remove all affected mucosa. Mohs surgery can be used. Thereafter, appropriate sunscreen application is recommended. 