Treatment according to Staging
The tumours are rated on a scale from 0-4 where T0 indicates no evidence of the primary tumour expanding into local tissue and the increasing numbers (T1-T4) correspond to the increasing size/extent of the tumour. Carcinoma in situ (Tis) describes an early cancer where the malignancy is contained within the epithelium (the top layer of cells lining the oral cavity and oropharynx) and has not grown into deeper tissue layers.
The involvement of the regional lymph nodes is rated as N1, N2 or N3 depending on the size and number of lymph nodes involved. N0 means that regional lymph nodes are cancer free. The metastases (spread) is labelled as either M0 (no sign of metastases) or M1 (the cancer has spread).
Each category (T, N and M) is assessed and rated. An X is used to denote insufficient information (the condition of the particular factor cannot be adequately assessed).
  Tumour Size   less than 2 cm    2 to 4 cm   4 cm more than 4cm
  Spread   No metastasis   No metastasis   lymph node  may be affected (a) lip and oral cavity
(b) muscles or bones of the oral cavity or skull base
(c) lungs
Treatment . . .
  Lip Surgery. Internal  radiation with or  without external  radiation  Surgery. External  radiation and/or  internal radiation  Surgery. External  radiation with or  without internal  radiation  Surgery. External  radiation with or  without internal  radiation
Front of the tongue Surgery.Internal radiation with or without external radiation. Radiation to lymph nodes in the neck Radiation and/or surgery. Internal radiation with surgery (neck dissection) External radiation with or without internal radiation. Surgery followed by radiation Surgery to remove the tongue and sometimes the larynx (voice box) with or without radiation. Radiation as palliative therapy to relieve symptoms and improve quality of life.
 Buccal mucosa  (lining of the  inside of the  cheeks)  Surgery for  tumours smaller  than 1  centimetre, with  or without  internal and/or  external   radiation.  Surgery or  radiation for  larger tumours.   Radiation for  tumours that are  3 centimetres or  smaller. Surgery  and/or radiation  therapy for  larger tumours.  Surgery with or  without radiation. Radiation   Surgery and/or  radiation
 Floor (bottom) of the  mouth  Surgery for  tumours smaller than ½  centimetres.  Surgery or  radiation for  larger tumours. Surgery.Radiation.  Surgery  followed by  external  radiation with or  without internal  radiation for  large tumours  Surgery which  may include   removing part  of the  jawbone, with or  without neck  dissection).
External radiation with or  without internal  radiation
 Surgery before  or after radiation  therapy.
 Lower gingiva   Surgery, which  include  removing part of  the jawbone  and skin graft.  Radiation with or  without surgery  Surgery which  may include  removing part of  the jawbone  and a skin  graft). Radiation  alone or after  surgery   Surgery with  or without  radiation.  Radiation may be  given before or  after surgery   Surgery and/or  radiation
 Retromolar  trigone (the  small area  behind the  wisdom teeth)  Surgery which  may include  removing part of the jawbone. Radiation with or without surgery   Surgery which  includes  removing part of  the jawbone.  Radiation with or  without surgery  Surgery to  remove the  tumour, lymph  nodes and part  of the jawbone,  with or without  radiation  Surgery to  remove the  tumour, lymph  nodes and part  of the  jawbone, followed  by radiation
  Upper gingiva  or hard palate  Surgery with or  without radiation   Surgery with or  without radiation. Radiation alone   Radiation. Surgery and radiation  Surgery with  radiation. Chemotherapy  and radiation
 Hard palate      Radiation.  Surgery with or  without radiation  
 Lymph nodes     Radiation  and/or surgery  (neck  dissection).  Radiation and/or  surgery (neck  dissection).
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