The Danish national guidelines for treatment of oral squamous cell carcinoma

Figures & data

Table I.  Treatment modality based on the UICC 1997 TNM classification.

Stage	I	II	III				IV
TNM	T1N0	T2N0	T1N1	T2N1	T3N0	T3N1	>T4>N0
T-site	Single modality treatment				Combined modality treatment
	-				-
N-site	Surgery or radiotherapy				Surgery and radiotherapy

Table II.  National guidelines in brief.

Single modality treatment and combined modality treatment are used (Table I)

Surgery is the preferred treatment in all cases where radical excision and reconstruction are judged to be possible

The operation is considered radical only if the microscopic surgical margin show no evidence of tumour within 5 mm of the margin on histological assessment

The resection of the lymph nodes is considered radical when there is no evidence of extra-capsular spread (capsular rupture) both macro- and microscopically

Levels with a risk of less than 10% of harbouring metastasis arenottreated

Selective neck dissection (I-III) and level IV for anterior tongue tumour is considered appropriate

Postoperative radiotherapy is indicated in case of a non-radical excision with regard to the primary tumour or the lymph nodes or if the classification of the regional lymph nodes is pN2 or higher.

Figure 1.  Decision tree for the treatment of oral SCC.