Outcomes of oral squamous cell carcinoma arising from oral epithelial dysplasia: rationale for monitoring premalignant oral lesions in a multidisciplinary clinic

Surveillance of oral epithelial dysplasia results in a number of newly diagnosed cases of oral squamous cell carcinoma (SCC). The clinical stage of oral SCC at diagnosis influences the magnitude of treatment required and the prognosis. We aimed to document the stage, treatment, and outcome of oral SCC that arose in patients who were being monitored for oral epithelial dysplasia in a dedicated multidisciplinary clinic. Those with histologically diagnosed lesions were enrolled on an ethically approved protocol and molecular biomarker study. Details of clinical and pathological TNM, operation, radiotherapy, recurrence, second primary tumour, and prognosis, were recorded in patients whose lesions underwent malignant transformation. Of the 91 patients reviewed (median follow-up 48 months, IQR 18-96), 23 (25%) had malignant transformation. All were presented to the multidisciplinary team with stage 1 disease (cT1N0M0). Of these, 21 were initially treated by wide local excision, 2 required resection of tumour and reconstruction, and 2 required adjuvant radiotherapy. At follow-up 3 had local recurrence, one had regional recurrence, one had metachronous lung cancer, and 5 had second primary oral SCC. There were further diagnoses of oral dysplasia in 5 during follow-up, and it is estimated that 76% of patients will have one or other event in 5 years. Disease-specific survival was 100% and overall survival was 96% (22/23). Median follow-up after diagnosis of oral SCC was 24 months (IQR 11-58). Specialist monitoring of oral epithelial dysplasia by a multidisciplinary team allows oral SCC to be detected at an early stage, and enables largely curative treatment with simple and usually minor surgical intervention. The high incidence of second primary oral SCC in high-risk patients with oral epithelial dysplasia further supports intensive targeted surveillance in this group.     

Second primary tumours after a squamous cell carcinoma of the oral cavity or oropharynx using the cumulative incidence method

The aim of this study was to define the incidence of second primary tumours (SPTs) after treatment of a first primary oral or oropharyngeal squamous cell carcinoma (SCC) and to define patient groups with an increased or decreased risk of developing SPT with adjustment for competing risks. Cancer registry data from 917 consecutive patients with primary oral or oropharyngeal SCC were reviewed. Outcomes considered were the incidence and location of the SPT. Cumulative incidence was assessed instead of cumulative risks for SPTs. 149 patients (16%) developed a metachronous SPT (median follow-up time 2.6 years). The 5-year and 10-year cumulative incidence was 13% (S.E. 1.2) and 21% (S.E. 1.7), respectively. Most SPT developed in the upper aerodigestive tract (n = 65) and lungs (n = 35). No statistically significant risk factors were identified when considering patient and index tumour characteristics. The advantage of this study was the large and homogeneous patient population and the correction for competing risks, resulting in a lower but more accurate estimation of the incidence of SPTs. Despite this lower, but still continuous risk, regular follow-up for over 10 years is indicated for all patients treated for cancer of the oral cavity and oropharynx.     

Clinical outcomes and prognostic factor analysis after salvage surgery for recurrent squamous cell carcinoma of the oral cavity

The purpose of this study was to analyze the oncological outcomes and predictive factors for successful curative salvage surgery after recurrent oral cavity squamous cell carcinoma. A retrospective study was conducted involving 73 patients who received surgery-based salvage treatment. The pattern of failure for primary treatment was local failure in 29 patients, regional failure in 29 patients, and loco-regional failure in 15 patients. The 5-year overall, loco-regional failure-free, and disease-free survival rates were 54.8%, 58.9% and 49.3%, respectively. Patients with an advanced initial N stage, previous treatment with combined modality therapy, loco-regional recurrence, advanced recurrent T stage, a disease-free survival of less than 8 months prior to salvage, and recurrence in a previously treated field had a significantly worse prognosis. Given the potential surgical morbidity, salvage surgery should be undertaken after careful consultation with patients who have factors for a poor prognosis.     

口腔鳞癌新辅助化疗的回顾性研究

目的 :探讨新辅助化疗在口腔鳞癌治疗中的近期和远期临床效果。方法 :对 1990 2 0 0 0年我院住院治疗的36例新辅助化疗口腔鳞癌患者和 72例术前未作任何辅助治疗的口腔鳞癌患者作回顾性分析 ,对化疗后临床肿瘤退缩程度、生存率、术后复发和转移率作比较。其中新辅助化疗组患者术前接受一个疗程的VM方案化疗后进行手术。结果 :新辅助化疗后临床完全缓解 6例 ,有 18例部分缓解 ,总有效率 6 6 .7%。在平均 4 8个月 (6 12 0个月 )的随访中 ,新辅助化疗组 12例出现复发 (33.3% )、3例 (8.3% )转移、6例 (16 .6 % )死于肿瘤 ,对照组 4 8例复发 (6 6 .7% ) ,2 0例 (2 7.8% )转移、2 8例 (38.9% )死于肿瘤 .两组差别有显著意义 (P <0 .0 5 )。结论 :新辅助化疗安全低毒、不影响手术、近期肿瘤缓解率明显、远期可减少术后复发和转移率、大大提高患者无瘤生存率     

The use of tobacco‐free betel‐quid in conjunction with alcohol/tobacco impacts early‐onset age and carcinoma distribution for upper aerodigestive tract cancer

J Oral Pathol Med (2011) 40 : 684–692 Background: Recognition of how risk factors affect the age when cancers are first diagnosed may help to establish more appropriate cancer screening and preventive strategies. Methods: To investigate the independent and synergistic effects of alcohol, tobacco‐free betel‐quid (TF‐BQ), and cigarette use on diagnosis age and dissemination of upper aerodigestive tract squamous cell carcinoma (UADT‐SCC), we recruited pathology‐proven 1522 patients with UADT‐SCC for study. Results: A 49‐, 53‐, 57‐, and 62‐year‐old stepwise older median age at carcinoma diagnosis was, respectively, found among patients with oral, pharyngeal, esophageal, and laryngeal cancer. Oral cavity (53.2%) and larynx (11.6%) were separately the dominant and recessive sites where the UADT‐SCC occurred. Although alcohol and tobacco bestowed increased risks of earlier tumor occurrence only for oral/pharyngeal and oral cancers, respectively, TF‐BQ was consistently observed to confer elevated age‐associated risks for each UADT‐SCC [adjusted hazard ratio (aHR) = 1.6–2.3]. Alcohol and TF‐BQ joint consumers experienced a stepwise increased cumulative risk (CR) of contracting carcinomas of the larynx (46.2%), esophagus (47.5%), pharynx (53.5%), and oral cavity (60.5–71.0%), with >68% of CRs found among drinkers who started chewing before age 20. Alcohol + Betel + Cigarette and Alcohol + Betel users exhibi‐ted earlier diagnosis ages than non‐users: 10 years ahead for oral cancer, 7, 17, and 12 years earlier for pharyngeal, esophageal, and laryngeal cancers. Noticeably, higher cumulative cancer risks regarding earlier tumor occurrence were correspondingly identified for these users aged 43, 49, 43, and 44 upward. Conclusions: Tobacco‐free betel‐quid, in conjunction with alcohol and/or tobacco consumption, impacts early cancer occurrence for specific UADT‐SCC and influences tumor site incidence pattern of these neoplasms.     

下颌骨舌侧松解进路治疗口腔癌的疗效评价

目的:评价改良手术进路-下颌骨舌侧松解进路(mandibular lingual releasing approach)治疗口腔癌的疗效.方法:回顾性分析2003年7月-2006年12月之间接受下颌骨舌侧松解进路方式治疗的口腔癌病例20例.采用病历对照方法,随机选取性别、年龄、原发部位和分期相当的20例下唇或下颌骨切开进路的患者作为对照组.比较2组的手术并发症、局部复发率和生存率.采用SPSS10.0软件包对数据进行统计学分析.结果:研究组20例,原发灶部位分别为:口底(8例)、舌活动部(6例)、舌根(2例)以及其他部位(4例).临床Ⅰ期2例、Ⅱ期4例、Ⅲ期6例、Ⅳ期8例.随访1～40个月,中位随访期15个月.采用Kaplan-Meier方法计算研究组和对照组的3年局部控制率分别为76.2%和64.9%(P=0.792);3年生存率分别为52.3%和50.0%(P=0.672).研究组和对照组并发症发生率分别是40%和30%(P=0.501).结论:初步结果显示,与传统下唇裂开或下颌骨切开进路比较,下颌骨舌侧松解进路方式治疗口腔癌,不影响肿瘤治疗效果,既克服了口腔进路受限制以及切除不彻底的弊病,又避免了下唇裂开进路在面部遗留瘢痕的弊端.手术后患者外观改变不明显,生活质量提高.     

腮腺原发性鳞状细胞癌的治疗及预后分析

目的 总结分析腮腺原发性鳞状细胞癌的预后相关因素及治疗策略.方法 回顾分析1970年3月至2005年3月收治并经病理证实的49例腮腺原发性鳞状细胞癌的临床资料,对有完整随访资料的44例应用SPSS 13.0统计软件进行分析.结果 44例获得随访患者的中位随访时间为38个月(5～215个月),术后21例复发、转移(腮腺局部或颈部淋巴结转移13例、伴有远处转移8例),局部复发是治疗失败的主要原因.49例中3年、5年的累计生存率为52%、27%,无瘤生存率分别为34%、16%.Kaplan-Meier和log-rank单因素分析显示,患者年龄、肿瘤大小、远处转移、术后放疗、面神经功能障碍、皮肤侵犯、术式及手术切缘、颈淋巴结清扫术均对患者的生存率有影响.Cox多因素分析结果表明,年龄、面神经功能障碍、远处转移及手术切缘是影响腮腺原发性鳞状细胞癌预后的重要因素.结论 手术及术后放射治疗是腮腺原发性鳞状细胞癌的最佳治疗方案,可以明显改善患者预后,降低术后复发率.     

Surgical salvage for local and regional recurrence in oral cancer.

PURPOSE: To evaluate local and regional recurrence and the outcomes for salvage surgery in patients for oral cancer. PATIENTS AND METHODS: This study analyzed 354 consecutive patients with oral cancer treated primarily by surgery or surgery combined with adjuvant therapy by 1 surgeon (R.A.O.) between February 1991 and September 2001. RESULTS: Overall recurrence rate was 15.5%; with 5.4% local, 8.5% regional, and 1.4% locoregional. Overall salvage for local recurrence was 52.6% 3-year survival, and statistically significant favorable prognostic factors were salvaged by surgery alone and initial cancer staging of I/II. Overall salvage for regional recurrence was 50%, with recurrence in a previously untreated neck and salvage with radical neck dissection plus radiotherapy giving the best prognosis. No patients with locoregional recurrence were salvaged. CONCLUSIONS: Patients who were stage I/II and were treated initially by surgery alone were the best candidates for salvage if they recurred. Salvage was best achieved with surgery or surgery + adjuvant therapy, and patients recurring within 6 months had a worse survival. Patients with locoregional recurrence or treated with RT +/- chemotherapy alone have negligible survival.     

Primary oral leiomyosarcoma: a retrospective clinical analysis of 20 cases

Oral Diseases (2010) 16 , 198–203 Purpose: As a review and clinical analysis of primary oral leiomyosarcoma (LMS) cases in West China stomatology Hospital in the past 37 years, this study provides demographic, therapeutic and prognostic information of this rare tumor. Patients and methods: In our study, 20 cases of primary oral LMS treated between 1972 and 2008 in West China Stomatology Hospital were analyzed retrospectively. A thorough review of clinical records was carried out and potential indicators of survival were analyzed. Results: The most common symptom of oral LMS presented as a painless mass. The median age of patients was 37 years, and the peak incidence age of this tumor was in the 2nd and 5th decades. There was no predilection of gender, and the male‐to‐female ratio was 11:9. The most frequently occurring site of oral leiomysarcoma was the jawbones. The prognosis of this tumor was poor as a result of the high local recurrence and the estimated 2 year survival was 17.6%. The bony involvement and method of therapy was observed to have an influence on the prognosis and survival of this tumor (P < 0.05). Conclusion: There was a predilection site of jawbones for oral LMS, and bony involvement was a potential indicator suggesting a poorer prognosis. The recommended method of therapy on this tumor was aggressive, radical surgical resection; however, adjuvant radiotherapy and chemotherapy may also have a beneficial effect.     

口腔癌浸润深度对改进肿瘤TNM分期及预后评价的影响

目的:分析比较美国癌症联合委员会(AJCC)第8版与第7版TNM分期系统在口腔癌临床治疗决策、预后分层以及提高预后评价准确性中的意义.方法:收集2009年1月—2015年6月手术治疗的原发口腔鳞状细胞癌患者,分别应用第7版、第8版TNM分期系统对肿瘤进行分期,比较2种分期的变化情况.采用SPSS 26.0软件包,运用K...     

Dermal metastases in oral cancer after curative treatment: a single institution cohort study

Dermal metastasis (DM) is, by definition, the involvement of the skin by cancer cells that originate from cancer elsewhere in the body. The skin is considered a rare site of distant failure in head and neck cancer and DM is the bearer of a poor outcome. Literature about it is limited so this study was undertaken to analyse the factors associated with its incidence and outcomes. A prospectively maintained database on operated cases of oral cancer at a tertiary cancer centre was analysed, and patients who developed dermal metastases during follow up were evaluated. Factors that contributed to early DM and predicted survival after its development were studied. A total of 68 patients (2.8%) had DM as the first presentation of recurrence after a median disease-free period of five months. Early DM was significantly associated with skin involvement by the primary tumour at the time of presentation (p = 0.06), extracapsular extension of nodes (p=0.004), and with those who required adjuvant chemotherapy in view of aggressive histology (p = 0.021). Median (range) survival after the detection of DM was 97 (5-328) days (3.25 months). Surgical excision of isolated cases was associated with significantly increased survival after detection (p = 0.05). Whenever it is feasible without too much morbidity, solitary DM should be excised.     

The prognostic significance of histological features in oral squamous cell carcinoma

Background:  Different factors predict nodal metastasis, recurrence and survival in oral cancer. The aim was to assess the prognostic value of histological features related to the primary tumour.
Methods:  A total of 144 patients surgically treated at Odense University Hospital for oral cancer between 1999 and 2004 were included in the study. Postoperative radiation therapy was given in case of close and involved margins or high TNM stages (UICC 1997). Median follow-up time was 38 months. All surgical resections were reviewed and 22 histological characteristics were assessed.
Results:  The predominant sites were floor of mouth (FOM, 39%) and lateral tongue (35%). Fifty-nine per cent had UICC97 stage I–II disease. Five-year cause-specific survival was observed in 65%. Nodal involvement at diagnosis was observed in 36% which was significantly related to grade, neural and vascular invasion; surgical margins and increasing tumour depth. A cut-off value of 2 mm (4 mm for FOM) separated patients without and with nodal metastasis at the time of diagnosis. However, on multivariate analysis, neck disease was only associated with tumour depth and grade. Cox analysis of local recurrence in the oral cavity over time showed that tumour diameter and surgical margins were significant predictors while cause-specific survival was related to diameter, depth of invasion, surgical margins and extracapsular spread (ECS).
Conclusions:  Tumour depth and grade were strong prognostic factors for nodal metastasis, independently of other histological features. Tumour diameter and margins independently predict local recurrences in the oral cavity as well as cause-specific survival. Nodal involvement and ECS were associated with adverse prognosis.     

Multiple primary tumours following head and neck cancer in southern England during 1961–98

BACKGROUND: Successful initial treatment of oral and oro-phayngeal cancer has led to the emergence of second primary tumours (SPTs). Population data are meagre. METHODS: Occurrence of multiple primary cancers following a malignancy in a head and neck site was computed using data from a population-based cancer registry covering a population of 14 million. RESULTS: Among 59,958 subjects reported to the registry, 5.5% males and 3.6% females developed a second primary cancer. At the sites studied, a total of 2771 second primary cancers were found, compared with an expected number of 2341. The standardised incidence ratio (SIR) for contracting a new primary cancer was 1.14 (95% CI=1.09-1.19) for men and 1.34 (95% CI=1.24-1.44) for women. There was a significantly increased risk for a second cancer in most of the upper aerodigestive tract sites that are generally regarded as tobacco associated, with an SIR for subsequent oral cancer of 5.56 in men and 15.31 in women. Subjects first detected with a pharyngeal cancer experienced the highest SIR for a subsequent tumour. Excluding tobacco-associated sites, the risk of a subsequent cancer was not significantly raised in either sex (SIR 0.87 (95% CI 0.81-0.93) for men; SIR 0.99 (95% CI 0.90-1.09) for women). CONCLUSIONS: The relative risk for multiple primary cancer was higher in younger subjects, those detected with a head and neck cancer during the 1990s as compared with earlier decades of the study, and among patients who received radiotherapy for their first tumour. By 20 years from the time of the first head and neck cancer, we estimate that approximately 30% of male patients and 20% of female patients will have developed an SPT.     

Second respiratory and upper digestive tract cancer following oral squamous cell carcinoma

727 patients with squamous cell carcinoma (SCC) of the lip and oral cavity have been followed for the occurrence of second primary tumours (SPTs) in the respiratory and upper digestive tract (RUDT). 74 patients (10%) developed at least one SPT in the RUDT. The incidence of SPTs was expressed per 1000 person-years of follow-up. In our study about 28 SPTs per 1000 person-years of follow-up were seen in the RUDT. Patients were at risk for a second primary tumour, at a steady rate of approximately 2.8% per year during at least 10 years. Furthermore, patients with an index tumour in the lower part of the mouth (floor of mouth, retromolar area and lower alveolar process), which is more related to tobacco and/or alcohol, seem to be more at risk for SPTs than patients with an index tumour in the other (sub)sites of the mouth.     

经首次根治性手术治疗口腔鳞状细胞癌患者的生存相关影响因素分析

目的分析口腔鳞状细胞癌(OSCC)患者的总体生存率,以及影响生存率的临床病理因素。方法采集对首次接受根治性外科手术治疗的78例OSCC患者的临床病理及随访资料进行回顾性分析。对计数、计量资料进行描述性分析;采用Kaplan-Meier法绘制生存曲线;采用COX比例风险回归模型进行单因素和多因素分析,分析患者的生存率及预后相关影响因素。结果最终纳入生存分析的患者共计68例,中位随访时间为63(6~87)个月,5年总体存活率为55.9%,随访期间因OSCC死亡患者的中位生存时间为20.5(6~52)个月。单因素分析表明,临床分期、原发灶大小、淋巴结转移、病理分化及复发转移是影响生存时间的暴露因素(P<0.05);多因素分析表明,病理分化、复发转移是影响生存时间的独立危险因素(P<0.05)。78例OSCC患者中合并发生食道鳞状细胞癌(ESCC)者有4例(5.1%)。结论根据肿瘤的临床分期(TNM分期)、原发灶大小、淋巴结转移、病理分化及复发转移可对患者的生存预后作出一定的预测,其中病理分化及复发转移是影响生存预后的独立危险因素。有吸烟饮酒史的OSCC患者应常规进行ESCC临床筛查。     

The impact of delayed diagnosis on the outcomes of oral cancer patients: a retrospective cohort study

The contemporary literature is discordant regarding the role of delayed diagnosis in the prognosis of patients with oral cancer. This study examined data on a previously reported cohort of 101 patients with oral squamous cell carcinoma diagnosed at a single institution between 2008 and 2010. The time interval between symptom onset and initial histological diagnosis (diagnostic delay) was recorded for each patient, as were demographic data and cancer features such as T stage, nodal status, and smoking status. The mean follow-up period was 4 years 10 months. The mean diagnostic delay was 4 months, mean overall survival was 5 years 6 months, and mean disease-specific survival was 4 years 9 months. No significant correlation was found between diagnostic delay and overall survival, disease-specific survival, or recurrence rates. Patients with node-positive disease were more likely to be diagnosed earlier, whereas women and non-smokers were more likely to have a delayed diagnosis. Inherent tumour biology is likely an important prognostic factor separate to diagnostic delay. Public education efforts should focus on symptom recognition and encourage early presentation for investigation of oral lesions, particularly for females and non-smokers, so that more aggressive tumours can be treated sooner to give the best chance at survival.     

肿瘤侵润方式及手术切缘评估对舌癌患者的意义

目的 :探讨肿瘤侵润方式和手术切缘情况对舌癌患者的意义。方法 :分析1987年1月～1994年12月75例舌癌患者的临床资料 ,以Anneroth等提出的将肿瘤侵润最深处宿主/肿瘤交界处组织的表现分四型来评估肿瘤不同的恶性程度。观察本组患者手术切缘情况,通过统计学方法将资料进行综合分析。结果 :肿瘤侵润Ⅲ～Ⅳ型患者的生存曲线明显低于Ⅰ～Ⅱ型;切缘阳性患者较阴性患者更易局部复发 ,但阳性者生存曲线较阴性者无明显下降。结论 :应用Anneroth等的肿瘤侵润分型系统 ,评估肿瘤的恶性程度 ,对舌癌患者预后的判断是重要的指征。手术切缘阳性患者较阴性者更易复发 ,通过术后放疗 ,阳性者的生存曲线无明显下降。     

Primary malignant melanoma of the oral mucosa.

PURPOSE: To present our experience on the epidemiology, clinical features, management, and survival of patients with oral malignant melanoma. PATIENTS AND METHODS: Records of patients with a histologic diagnosis of primary oral mucosal malignant melanoma seen over a 23-year period were retrospectively reviewed. RESULTS: There were 6 females and 2 males, ranging in age from 18 to 60 years; 4 cases in the maxilla, 2 in the mandible, 1 on the lower lip, and 1 on the buccal mucosa. Local recurrences developed in 2 patients who eventually died with clinical metastatic cervical nodal disease. Follow-up ranged from 6 months to 16 years 3 months. Surgery was the only treatment available. CONCLUSION: Primary oral mucosal melanoma is rare, with a 3 to 1 female to male ratio and an average age of 41.7 years at presentation. It is most common in the maxilla and has poor prognosis despite apparent adequate local surgical control.     

Marginal and segmental mandibulectomy in patients with oral cancer: a statistical analysis of 106 cases.

PURPOSE: The treatment of oral squamous cell carcinoma may require mandibular resection to secure adequate margin. This bone resection often is segmental or marginal mandibulectomy. The purpose of this work was to evaluate the local control and survival after surgical treatment of oral cancer, according to these 2 different mandibular resection procedures. PATIENTS AND METHODS: We conducted a retrospective study of a 20-year cohort of 106 patients who underwent marginal or segmental mandibulectomy for oral cancer. All patients had a biopsy-confirmed diagnosis of squamous cell carcinoma involving either the floor of the mouth, mandibular gingiva, retromolar trigone, tongue, buccal mucosa, or oropharynx. The type of mandibular resection and treatment outcome were compared, using an univariate analysis by the Pearson chi(2) test, logistic regression model for multivariate analysis, and Kaplan-Meier method to determine survival. RESULTS: The 5-year observed survival rate was 60.35%. The presence of histologic mandibular invasion increased the local recurrence rate. Early tumor stages (P =.02) were found to be associated with decreased local recurrence rates. Our findings indicate that tumor stage and size of mandibulectomy are more important than the type of mandibulectomy in predicting histologic bone involvement. The cases treated with a greater than 4 cm bone resection showed a lower survival rate than those treated with less than 4 cm mandibulectomy (P =.01). Patients in advanced stages (P =.006) and those with surgical margin (P =.0001) or the bone (P =.003) affected by the tumor showed a statistically significant lower survival rate. However, no statistically significant differences were found between patients treated by marginal or segmental mandibulectomy. CONCLUSIONS: Among the prognostic factors studied, the status of the surgical resection margin, the bony involvement and the size of mandibulectomy affected the prognosis for oral carcinoma. Mandibular conservation surgery is oncologically safe for patients with squamous carcinoma in early stages. The marginal technique was not associated with worse prognosis.     

Clinical evaluation on controlling postoperative recurrence of oral squamous cell carcinoma by intracavity brachytherapy

The purpose of this research was to evaluate the clinical outcome and factors influencing postoperative intracavity brachytherapy in treating oral squamous cell carcinoma. As a part of their primary treatment, 108 patients received postoperative intracavity brachytherapy only and 85 patients received postoperative intracavity brachytherapy with external radiotherapy. 78 patients were given surgical treatment alone as a control. The survival rates and local tumor control rates were calculated and the therapeutic effects of various treatment methods compared. Overall 5- and 10-year survival rates for patients receiving surgical treatment alone, postoperative intracavity brachytherapy with or without external radiotherapy were 59% and 17%, 73% and 47%, 78% and 57%, respectively. The corresponding local tumor control rates were 53% and 51%, 73% and 71%, 75% and 73%, respectively. Surgical treatment with postoperative intracavity brachytherapy controlled tumor recurrence effectively (p < 0.01) and improved survival rates (p < 0.01). UICC stages, grading and tumor site had an important influence on overall survival and local tumor control rates. Local tumor excision followed by postoperative intracavity brachytherapy achieved good local tumor control and survival rate, and may be considered as a new and routine treatment for oral cancer.