53 Oral cavity cancer

ACKNOWLEDGEMENTS The authors acknowledge Professor RJ Shaw , Professor JS Brown and Professor C B...

ADJUVANT THERAPY FOR THE MANAGEMENT OF ORAL CA VITY CANCER While primary chemoradiotherapy can be...

ADJUVANT THERAPY FOR THE MANAGEMENT OF ORAL CA VITY CANCER While primary chemoradiotherapy can be...

Adjuvant chemoradiotherapy The landmark RTOG 9501 and EORTC 22931 randomised - trials form the ba...

Biopsy Primary tumour Histopathological diagnosis via a formal biopsy is the gold standard prior ...

Bone invasion Three patterns of bone invasion, namely infiltrative, erosive or mixed, have been d...

DIAGNOSIS AND WORK-UP These can be summarised as follows: /uni25CF history and examination; /uni2...

EPIDEMIOLOGY There is considerable geographical variation in the incidence of oral cancers world...

Histological type The vast majority of OCSCCs are conventional squamous-type carcinomas, reflecti...

Imaging Contemporary cross-sectional imaging techniques are essen - tial in the management of he...

Immunotherapy Antitumour immunotherapy is based on the principle that tumours can sometimes escap...

Incidence There are approximately 350 /uni00A0 000 new cases of oral cavity cancer per year worl...

INTRODUCTION The oral cavity ( Figure 53.1 ) extends from the mucosal surface of the lips to the...

Learning objectives To understand: The epidemiology and aetiology of oral cancer • The cardinal f...

Lymphovascular invasion LVI represents the presence of tumour cells within an endothelium-lined ...

M stage Routine assessment of the chest (as a minimum) for evidence of distant metastasis and/or...

MANAGEMENT OF RECURRENT AND/OR METASTATIC DISEASE Patients with a low burden of disease or oligo...

Metastases As outlined previously , HPV-negative cervical node metastases are associated with dec...

Molecular biology According to The Cancer Genome Atlas (TCGA), alterations in p53 (83%) and CDKN2...

N stage The system for describing the anatomy of regional lymph node metastases has been well de...

Neck lump Fine-needle aspiration cytology (FNAC) is the first-line biopsy for the investigation of...

Oral cavity All sites in the oral cavity are examined under direct visual - isation. Table 53.4 d...

PATHOLOGY OF ORAL CANCERS The vast majority (>95%) of oral cavity cancers are squamous cell carc...

Patient selection As outlined previously , patients’ comorbidities and functional status as well ...

Pattern of invasion The pattern of invasion refers to the shape of the advancing front or borde...

Perineural invasion While there is no clear consensus on the criteria for diagnos ing PNI, it is ...

Prognostic stage groupings The eighth edition AJCC stage groupings are outlined in Table 53.3 . -...

REFERENCES 1 Coelho KR. Challenges of the oral cancer burden in India. J Cancer Epidemiol 2012; ...

Reconstruction Reconstruction following tumour ablation is a key component in the management of O...

Regional variations Oral cancer is one of the most common cancers in India, 1 with an age-adjuste...

Risk factors Tobacco, alcohol and betel quid (areca nut, catechu, slaked lime wrapped in a piper ...

STAGING Staging is required to document tumour size, location and disease extent, as well as to f...

SURGICAL MANAGEMENT Surgery , with adjuvant radiotherapy (or chemoradiotherapy) if indicated, rem...

T stage The size and extent of tumours are typically determined by thorough clinical examination...

The neck All levels of the neck must be palpated thoroughly , to assess for lymphadenopathy . Ho...

Tumour grade (differentiation) Often cited as an important prognosticator, the ‘WHO grade’ is bas...

Tumour thickness and depth of invasion Tumour thickness is measured as the maximum vertical dimen...