Oral cancer: Location, staging, surgical management, and outcomes

Abstract

Although substantial advances in adjuvant radiotherapy and chemotherapy for cancers of the oral cavity and neck have been made in recent years, surgery will be the preeminent approach for the treatment of the 46,000 new US patients in 2015 (Cancer Facts and Figure 2015). Squamous cell carcinoma is the predominate form of cancer that occurs in the head and neck (HNSCC) and is classified by location; it can occur in the oral cavity (mouth), nasal cavity or paranasal sinuses, nasopharynx (upper section of the throat), oropharynx (midsection of the throat), hypopharynx (lower part of the throat), and larynx (voice box). Despite the large number of new cases of HNSCC every year, the National Cancer Institute spent only ~$7 million of its nearly $3 billion FY2013 budget (0.002 %) on laryngeal and pharyngeal cancer research (http://fundedresearch.cancer.gov). Esophageal cancers (between the pharynx and the stomach), which are considered a digestive disease are also predominately SCCs, will register as additional 17,000 US patients this year. As nonsurgical approaches to treating HNSCC lag egregiously behind the progress realized in many other cancers, and funding for research is negligible, nearly all 46,000 new patients will face surgical intervention and the associate comorbidities. This chapter will focus specifically on the diagnosis, staging, surgical treatment, and expected outcomes of patient with oral cavity and neck cancers.