Abstract
The outcomes of the surgical management of oral malignant tumor treated in our clinic over the past 24 years were analyzed and reviewed regarding the following items ; 1) characteristics of the clinical features of 888 oral malignant tumors, 2) clinicopathological features and treatment results of 481 surgical cases with oral squamous cell carcinoma, 3) treatment methods and results for squamous cell carcinoma over a 21 year period divided into three terms (term 1, 2, 3), 4) systematic treatment of oral squamous cell carcinoma based on biopsy methods, 5) various kind of neck dissection for each N-stage. The disease specific 5-years cumulative survival rate for all 481 cases with oral squamous cell carcinoma was 77.0% and was favorably improved up to 87.2% for the latest (3rd) term. We were led to the conclusion that the improvement in the survival rate was due to employment of excisional biopsy with a safe excised margin by frozen section diagnosis for early cancer, surgery with special reference to stage, malignancy and chemotherapeutic effect, and neck dissection for early lymph node metastasis. The main prognostic factors were N-stage and mode of invasion.
