Oral Tongue Cancer

Introduction

  • In 2021, it is estimated that about 54, 010 new cases of oral cavity and pharyngeal cancer will develop:
    • Which represent approximately 2.8% of all cancers in the United States
  • During the same time period it is estimated that there will be approximately 10, 850 deaths:Which represent 1.8% of all cancer deaths in the USA
  • Incidence rates are more than twice as high in men as in women
  • From 2006 to 2010 incidence rates:Remained stable in men and have decreased by 0.9% per year in women
  • From 2005 to 2014, incidence rates:Decreased by more than 2% per year among blacks, but increased by about 1% per year among whites:Largely driven by rising rates for a subset of cancers associated with human papillomavirus (HPV) infection that arise in the oropharynx
  • Death rates have been decreasing over the past three decades:From 2006 to 2010, rates decreased by 1.2% per year in men and by 2.1% per year in women
  • In 2022, it is estimated that 17,960 new cases of oral tongue cancer will occur:13,040 will occur in men4920 will develop in women:One third of the cases will develop in women)
  • The estimated death rate from oral tongue cancer in 2021 is 2,870 deaths
  • Most head and neck cancers present with metastatic disease at the time of diagnosis:With regional nodal involvement and distant metastatic disease in 43% and 10% of the cases, respectively
  • Head and neck cancer patients often develop second primary tumors:This is because they share common risk factors
    • These second primary tumors develop at an annual rate of 3% to 7%:50% to 75% of these new cancers are located in upper aero digestive tract or lungs.

Surgical anatomy of the oral cavity

  • Boundaries of the oral cavity:Superior border-from the vermillion border to the junction of the hard and soft palates.Inferior border-from the vermillion border to the circumvallate papillae of the oral tongue.The lateral border-is the mucosa of the mouth up to the anterior tonsillar pillars.

early_stage_oral_cavity_cancer-fig_1-en

  • The oral cavity includes the lips, buccal mucosa, upper and lower alveolar ridges, gingiva, retromolar trigone, floor of mouth, hard palate and the anterior two thirds of the tongue (“oral tongue”).
  • The main lymphatic drainage is to level IA (submental triangle), IB (submandibular triangle) and II (upper deep jugular nodes).

https://www.oatext.com/pdf/CRR-2-153.pdf

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  • What is Head and Neck Surgery?:
    • It is a surgical sub-specialty that deals mainly with benign and malignant tumors of the head and neck region, including:
      • The scalp, facial region, eyes, ears, nose, nasal fossae, paranasal sinuses, oral cavity, pharynx (nasopharynx, oropharynx, hypopharynx), larynx (supraglotic larynx, glottis larynx, subglotic larynx), thyroid gland, parathyroid gland, salivary glands (parotid glands, submandibular glands, sublingual glands, minor salivary glands), soft tissues of the neck, skin of the head and neck region.
        • The head and neck surgeon’s work area:Does not cover tumors or diseases of the brain and other areas of the central nervous system or those of the cervical spine:This is the neurosurgeon field.
    • Among the diagnostic procedures performed by the head and neck surgeon,  are the following:
      • Nasopharyngolaryngoscopy:
        • Performed to examine, evaluate and, possibly perform a biopsy, of oral cavity, pharyngeal and laryngeal lesions.
    • The surgeries most commonly performed by the head and neck surgeon are:
      • Total or near total thyroidectomies
      • Hemithryoidectomies (lobectomies)
      • Comprehensive neck dissections
      • Selective neck dissections
      • Maxillectomies:
        • Total maxillectomy
        • Subtotal maxillectomy
        • Infrastructure maxillectomy
        • Suprastructure maxillectomy
        • Medial maxillectomy
      • Mandibulectomy:
        • Segmental
        • Marginal
      • Tracheostomy
      • Salivary gland surgeries:
        • Parotid gland operations:
          • Limited superficial parotidectomy with identification and preservation of the facial nerve
          • Superficial parotidectomy with identification and preservation of the facial nerve
          • Near total parotidectomy with identification and preservation of the facial nerve
          • Total parotidectomy
        • Submandibular gland resection
        • Sublingual gland resection
      • Resection of tumors of the oral cavity:
        • Glossectomy
        • Resection of the floor of the mouth tumors
      • Resection of tumors of the pharynx
      • Resection of tumors of the larynx
      • Split-thickness skin grafts
      • Full-thickness skin grafts
      • Sentinel lymph node mapping and sentinel lymph node biopsy
      • Resection of malignant skin tumors (BCC, SCC, melanoma) of the head and neck region
  • The formation of the head and neck surgeon includes mastering the following subjects:
    • Surgical Anatomy
    • History and Basic Principles of Head and Neck Surgery
    • Epidemiology, Etiology, and Pathology of Head and Neck Diseases
    • Diagnostic Radiology of the Head and Neck Region
    • Tumors of the Scalp, Skin and Melanoma
    • Eyelids and Orbit
    • Nasal Cavity and Paranasal Sinuses
    • Skull Base and Temporal Bone
    • Lips and Oral Cavity
    • Pharynx and Esophagus
    • Larynx and Trachea
    • Cervical Lymph Nodes
    • Thyroid and Parathyroid Glands
    • Salivary Glands
    • Neurogenic Tumors and Paragangliomas
    • Soft Tissue Tumors
    • Bone Tumors and Odontogenic Lesions
    • Reconstructive Surgery
    • Oncologic Dentistry and Maxillofacial Prosthetics
    • Principles of Radiation Oncology
    • Principles of Chemotherapy
    • Molecular Oncology, Genomics and Immunology
    • Nutrition
    • Biostatistic

 

Rodrigo Arrangoiz MS, MD, FACS a head and neck surgeon / endocrine surgeon / surgical oncologist and is a member of Mount Sinai Medical Center:

 

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  • Rodrigo Arrangoiz MS, MD, FACS, FSSO:
    • Is a member of the American Head and Neck Society

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Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

#Arrangoiz

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#CirugiaEndocrina

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#OralCavityCancer

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#Miami

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