Cancer of the Floor of the Mouth

Conclusions

Early floor-of-mouth tumors can be treated equally well with irradiation or surgery. Generally, surgery is preferred for lesions close to the mandible. Patients with palpable nodes in the neck should undergo a therapeutic neck dissection, with postoperative neck irradiation being reserved for patients with multiple positive nodes or extracapsular extension of the cancer. Treatment of clinically negative necks in patients with small lesions is controversial. Although observation may be considered, approximately 30% fail, and not all can be salvaged. Most physicians favor elective treatment of the clinically negative neck, using irradiation or surgery, the choice dictated by how the primary lesion is treated. Large lesions are treated with surgery followed by irradiation of the primary tumor site. The neck should be treated regardless of nodal status.