I am pleased to share our recent publication:
“Oral Cavity Squamous Cell Carcinoma: Contemporary Evidence-Based Management and Multidisciplinary Care”
In this comprehensive review, Fernando Cordera and I examine the evolving management of oral cavity squamous cell carcinoma (OCSCC), a disease in which surgery remains the cornerstone of treatment, but where optimal outcomes increasingly depend on precise risk stratification and coordinated multidisciplinary care.
Several important concepts emerge from the contemporary evidence:
🔹 Depth of invasion (DOI) matters. DOI has become a critical prognostic variable in oral cavity SCC, influencing T classification, the risk of occult cervical nodal metastasis, and decisions regarding management of the clinically N0 neck.
🔹 The neck must be addressed appropriately. Elective neck treatment remains a fundamental component of management for patients at meaningful risk of occult nodal disease. Sentinel lymph node biopsy is also emerging as an effective alternative to elective neck dissection in appropriately selected early-stage patients and experienced centers.
🔹 Pathology drives postoperative treatment. Margin status, nodal burden, extranodal extension, perineural invasion, lymphovascular invasion, and DOI are central to postoperative risk stratification and decisions regarding adjuvant radiation or chemoradiation.
🔹 Surgery is evolving toward oncologic control with functional preservation. Achieving adequate oncologic resection remains paramount, but contemporary treatment must simultaneously consider speech, swallowing, reconstruction, appearance, and long-term quality of life.
🔹 Immunotherapy is changing the treatment landscape. The KEYNOTE-689 trial represents an important shift in the management of selected patients with locally advanced, resectable head and neck squamous cell carcinoma, demonstrating improved event-free survival with the integration of perioperative pembrolizumab into standard treatment.
Perhaps the most important message is that oral cavity cancer can no longer be approached as surgery alone. Optimal care requires integration of head and neck surgical oncology, reconstructive surgery, radiation oncology, medical oncology, pathology, radiology, dentistry, speech and swallowing rehabilitation, nutrition, psychosocial support, and survivorship care.
Our goal with this review was to bring together the contemporary evidence—from epidemiology, anatomy and staging to surgical management, neck dissection, reconstruction, adjuvant therapy, immunotherapy, surveillance, recurrence, and survivorship—into a practical framework for clinicians treating patients with oral cavity cancer.
Reference:
Arrangoiz R, Cordera F. Oral Cavity Squamous Cell Carcinoma: Contemporary Evidence-Based Management and Multidisciplinary Care. JSM Head Neck Cancer Cases Rev. 2026;6(1):1013.
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Rodrigo Arrangoiz MS, MD, FACS, FSSO 