Controversial and Challenging Issues in Oral Cancer Surgery

PROGRAM DESCRIPTION: The incidence of oral cavity cancer among male individuals in Asia continued to increase. Despite the improvement in technology and health care, the overall survival rate of oral cancer didn’t change largely. There are some controversial or challenging issues in oral cancer surgery-like compartment resection vs wide resection, adjuvant radiotherapy in pN1 disease, rate of clear margin and etc.
The main issues discussed were as the followings:
(1) Compartment vs wide resection in oral cavity cancers: In contrast to wide resection, compartment resection adopted another resection philosophy, resection on the basis of anatomy of the site and pattern of tumor spread, resection from posterior to anterior/from deep to superficial direction, and ligation of feeding artery. We will perform literature review and case-based discussion to compare the difference between compartment resection versus wide resection and indication for selection of surgical method.

(2) Postoperative radiotherapy (PORT) versus surgery alone in pN1 oral cavity cancer: PORT was recommended for N2 and N3 patients; however, the benefits of PORT for patients with a single pathologically positive ipsilateral lymph node (pN1) without ENE remain contentious. Participants will critically examine the ongoing controversies surrounding the treatment strategy, covering both essential criteria and recommended practices. The lecture will comprehensively examine current evidence and associated considerations in evaluating the need for PORT, including clinicopathological features, lymph node yield, and types of neck dissection.

(3) Evolution and controversies in resection margin in oral cancer: Participants will engage in a critical examination of ongoing debates regarding RM adequacy, addressing both the minimum requirements and optimal practices. The session will also explore the best methods for obtaining, orienting, and assessing RM. Additionally, the lecture will introduce emerging technologies in RM assessment, including state-of-the-art, real-time, in-vivo, AI-assisted methodologies.