For patients with curatively resectable oral cavity carcinoma who are fit for surgery, the treatment approach centres on obtaining complete surgical control of both the primary tumour and the regional lymph nodes, while integrating reconstructive planning from the outset.

Where the patient's general condition permits, the recommended strategy involves surgical resection of the primary tumour with the aim of achieving tumour-free resection margins, combined with immediate reconstruction as part of a unified surgical concept. The management of regional lymph nodes — including the appropriate form of neck dissection — is determined by clinical lymph node status and forms an integral part of the overall plan.

The complete protocol specifies the full surgical algorithm, patient selection criteria, dissection levels, and additional treatment options available in selected cases — see the full protocol below.

The primary objective is complete tumour resection with histologically tumour-free resection margins (R0) at the conclusion of curative-intent surgery.

References

If the patient's general condition permits, surgery should be performed for curatively resectable oral cavity carcinomas, if necessary in combination with immediate reconstruction.
Reconstructive measures shall always be part of a surgical concept.
Patients with clinically unremarkable lymph node status (cN0) shall undergo elective neck dissection regardless of T category.
If lymph node involvement is clinically suspected (cN+), appropriate neck lymph node excision, usually a modified radical neck dissection, shall be performed.
Patients with small and accessible tumors (T1 / T2) of the oral cavity can be treated by interstitial brachytherapy in selected cases.
As often as possible R0 status after completion of curative intended surgical therapy.

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What Is the Surgical Treatment of Oral Cavity Cancer?