Cancer of the floor of the mouth

Early tumors (T1-2) located in the anterior aspect of the FOM are amenable for peroral excision, while larger tumors (T3-4) with lateral and posterior extension requires a surgical approach (cheek flap or visor flap) in order to adequately expose the primary tumor and its boundaries (vicinities) to allow tridimensional resection. Adequate evaluation of tumor invasion of the mandible is critical for treatment planning. Reconstruction of the surgical defect is of utmost importance to prevent fibrosis and contracture-impairing function, particularly when deep portions of the FOM (reaching the underlying musculature) are included in the surgical specimen. High rates of regional metastases, even in early stages, and the poor salvage rates found despite the use of aggressive therapy are strong arguments in favor of elective treatment of the neck in FOM cancer patients.