Oral cancers: Current status

Oral Oncol. 2018 Dec:87:64-69. doi: 10.1016/j.oraloncology.2018.10.013. Epub 2018 Oct 24.

Abstract

Oral cancer is a global disease. Despite a well elucidated tumour progression model, these cancers present late. Attempts at early detection by way of adjunctive diagnostic technologies and screening have not lived up to expectations in spite initial promise. Surgery is the mainstay of treatment. Treatment intensification by way of adjuvant radiation/chemo radiation is warranted for those with high risk features. Recent studies have explored intensification in those with intermediate risk factors in an attempt to improve outcomes. There has been generation of recent robust evidence that has influenced the need and extent of neck dissection. Neoadjuvant chemotherapy (NACT) may have a potential role in organ preservation and borderline resectable oral cancers. Recurrent tumours should be offered surgery whenever feasible while the addition of biological agents to chemotherapy gives best results in the palliative settings.

Keywords: Chemotherapy; Head and neck neoplasm; Head and neck neoplasms/diagnostic imaging; Monoclonal antibodies; Neck dissection; Neoadjuvant therapy; Oral cancers; Oral cancers/surgery; Radiotherapy.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Immunological / therapeutic use
  • Chemoradiotherapy, Adjuvant / methods
  • Chemoradiotherapy, Adjuvant / standards
  • Disease-Free Survival
  • Evidence-Based Medicine / methods*
  • Evidence-Based Medicine / standards
  • Humans
  • Lymphatic Metastasis / diagnosis
  • Lymphatic Metastasis / pathology
  • Mouth Neoplasms / mortality
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / therapy*
  • Neck Dissection / methods
  • Neck Dissection / standards
  • Neoadjuvant Therapy / methods
  • Neoadjuvant Therapy / standards
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy*
  • Organ Sparing Treatments / methods*
  • Organ Sparing Treatments / standards
  • Palliative Care / methods
  • Palliative Care / standards
  • Practice Guidelines as Topic
  • Randomized Controlled Trials as Topic
  • Sentinel Lymph Node Biopsy / methods
  • Sentinel Lymph Node Biopsy / standards

Substances

  • Antineoplastic Agents, Immunological