Oral cavity and lip cancer: United Kingdom National Multidisciplinary Guidelines

Abstract

This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It provides recommendations on the assessment and management of patients with cancer of the oral cavity and the lip.Recommendations• Surgery remains the mainstay of management for oral cavity tumours. (R)• Tumour resection should be performed with a clinical clearance of 1 cm vital structures permitting. (R)• Elective neck treatment should be offered for all oral cavity tumours. (R)• Adjuvant radiochemotherapy in the presence of advanced neck disease or positive margins improves control rates. (R)• Early stage lip cancer can be treated equally well by surgery or radiation therapy. (R)

Cancer Stem Cells in Moderately Differentiated Lip Squamous Cell Carcinoma Express Components of the Renin–Angiotensin System

“…Treatment for lip SCC includes surgery and radiotherapy singly as primary treatment, or in combination for advanced or higher grade lesions (10). While 5-year survival rates for oral cavity cancer are around 50–60% (1, 3), lip cancers have 5-year survival rates of up to 90% (2).…”

Our clinical approach to lip cancer; surgery and reconstruction principles

“…Rekonstruksiyon prensipleri ele alındığında Ulusal Birleşik Krallık multidisipliner guidelinenında (25) alt dudağın ½ sinden küçük defektlerde primer kapatma işlemi yeterlidir. Dudağın 1/2 ve 2/3'si arasında olan defektlerde üst dudaktan tam kat pediküllü flep (abbe, estlander) veya karapandzic flebi kullanılma-lıdır.…”

Depth of invasion alone as an indication for postoperative radiotherapy in small oral squamous cell carcinomas: An International Collaborative Study

“…In most institutions, resectable oral squamous cell carcinoma (SCC) is treated with primary surgery with the addition of PORT ± chemotherapy in the presence of adverse pathological features. Although there is institutional variation in practice, the generally accepted indications for PORT include compromised surgical margins, locally advanced disease (>4 cm in size), the presence of perineural or lymphovascular invasion, poorly differentiated tumors, and N2‐3 nodal disease with or without extracapsular spread . Although PORT reduces recurrence risk, the extent of benefit needs to be weighed in each patient against health care costs, side effects of treatment, and potential for long‐term sequelae such as xerostomia, dental caries, dysgeusia, osteoradionecrosis, trismus, lymphoedema, fibrosis, and dysphagia …”

“…Although there is institutional variation in practice, the generally accepted indications for PORT include compromised surgical margins, locally advanced disease (>4 cm in size), the presence of perineural or lymphovascular invasion, poorly differentiated tumors, and N2-3 nodal disease with or without extracapsular spread. [1][2][3] Although PORT reduces recurrence risk, the extent of benefit needs to be weighed in each patient against health care costs, side effects of treatment, and potential for long-term sequelae such as xerostomia, dental caries, dysgeusia, osteoradionecrosis, trismus, lymphoedema, fibrosis, and dysphagia. 4 Depth of invasion (DOI) of the primary tumor is well established as an independent predictor of recurrence and survival in oral SCC [5][6][7][8][9][10][11][12][13][14][15][16][17][18] resulting in its recent inclusion in the 8th edition American Joint Committee on Cancer Staging Manual.…”