Abstract

This study was conducted to determine the pattern of nodal metastasis and evaluate the different modalities of treatment adopted for different clinical stages of malignancies of the oral cavity. Methods: This study was conducted among 325 patients who presented with malignancies of the oral cavity to the Department of Otolaryngology – Head and Neck Surgery, Travancore Medical College, Kollam, over a period of 5 years from January 2017 to December 2021. Treatment included surgery, RT, CT or a combination of two or more of them. All patients have been followed to date. Results: Level I was the most common level of lymph nodes involved. Biopsy from the lesion and FNAC from the lymph nodes were sufficient in most of the cases to reach a proper diagnosis. Surgery with or without postoperative radiotherapy was the preferred modality of treatment in early cases, while primary radiotherapy alone was employed in the majority of cases with late-stage disease. Surgical margins were positive in 17.5% of the cases. Recurrence rates were higher when radiotherapy alone was employed. Treatment failures occurred more commonly at the primary site than at the nodal sites. Immunostaining of tissue sections with anti-5-mc antibodies showed increased staining with the progression of the stage of carcinogenesis. Conclusion: To optimize survival, the therapeutic approach requires careful planning on the part of an integrated team of head and neck specialists, including the surgeon and the radiotherapist.

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