Stage I Lip and Oral Cavity Cancer

Surgery and/or radiation therapy may be used, depending on the exact site.[1,2]

Small Lesions of the Lip

Standard treatment options:

1. Surgery.
2. Radiation therapy.

Surgery and radiation therapy produce similar cure rates, and the method of treatment is dictated by the anticipated cosmetic and functional results.

Small Anterior Tongue Lesions

Standard treatment options:

1. Wide local excision is often used for small lesions that can be resected transorally.
2. For patients with larger T1 lesions, the following standard treatments are used:
   1. Surgery.
   2. Radiation therapy.
   3. Interstitial implantation alone or with external-beam radiation therapy.
   4. Irradiation of the neck.

Small Lesions of the Buccal Mucosa

Standard treatment options:

1. Surgery alone for patients with lesions smaller than 1 cm in diameter, if the commissure is not involved.
2. Radiation therapy, including brachytherapy, should be considered to treat lesions smaller than 1 cm in diameter, if the commissure is involved.
3. Surgical excision with a split-thickness skin graft or radiation therapy is used to treat larger T1 lesions.

Small Lesions of the Floor of the Mouth

Standard treatment options:

1. Surgery for patients with T1 lesions.
2. Radiation therapy is used to treat T1 lesions.
3. Excision alone is generally adequate to treat lesions smaller than 0.5 cm, if there is a margin of normal mucosa between the lesion and the gingiva.
4. Surgery is often used, if the lesion is attached to the periosteum.
5. Radiation therapy is often used, if the lesion encroaches on the tongue.

Small Lesions of the Lower Gingiva

Standard treatment options:

1. Intraoral resection with or without a rim resection of bone and repair with a split-thickness skin graft are used to treat small lesions.
2. Radiation therapy may be used for small lesions, but results are generally better after surgery alone.

Small Tumors of the Retromolar Trigone

Standard treatment options:

1. Limited resection of the mandible is performed for early lesions without detectable bone invasion.
2. Radiation therapy may be used initially, if limited resection is not feasible, with surgery reserved for radiation failure.

Small Lesions of the Upper Gingiva and Hard Palate

Standard treatment options:

1. Surgical resection is used to treat most small lesions.
2. Postoperative radiation therapy may be used, if appropriate.

Current Clinical Trials

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage I lip and oral cavity cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.

General information about clinical trials is also available from the NCI Web site.

References:

1. Harrison LB, Sessions RB, Hong WK, eds.: Head and Neck Cancer: A Multidisciplinary Approach. Philadelphia, Pa: Lippincott-Raven, 1999.
2. Guerry TL, Silverman S Jr, Dedo HH: Carbon dioxide laser resection of superficial oral carcinoma: indications, technique, and results. Ann Otol Rhinol Laryngol 95 (6 Pt 1): 547-55, 1986 Nov-Dec.