Surgical or Non-surgical Treatment for Advanced Oral Cavity Cancer

Abstract

Surgery remains the standard of care for oral cavity squamous cell carcinoma despite advances in organ preservation for other head and neck cancer subsites. This chapter seeks to elucidate the efficacy between surgical and non-surgical options for the treatment of advanced stage oral cavity squamous cell carcinoma. The PubMed and MEDLINE databases were searched for relevant articles pertaining to this topic. The results were limited to English only and the oldest article included was from 2009. One randomized controlled trial and two large database retrospective reviews were included. All three of these articles favored surgical resection and adjuvant therapy over definitive chemoradiotherapy based on improved overall survival and/or disease-specific survival with surgery. Five retrospective cohort studies were included with mixed results. Two of these studies found both interventions were equivalent in regards to overall survival, while one retrospective cohort study showed equivalent overall survival but improved locoregional control with surgery. Two retrospective cohort studies favor surgery based on higher progression-free survival and overall survival results. Overall the data show that patients with advanced stage oral cavity squamous cell carcinoma should be treated with surgical resection and appropriate adjuvant therapy.