Cancer of the floor of the mouth: surgical management.

After discussing the changing incidence and known difficulties in the management of mouth floor cancer, reasons are given for the increased use of surgery in treating the more extensive lesions. The significance of the topographic anatomy, patterns of lymph drainage and surgical pathology is emphasized. Principles of treatment, indications and types of operation are discussed for the main lesions encountered. Following this the preparation of patients for surgery, the methods of anaesthesia and certain technical details of surgical treatment are given. The importance of after-care and particular measures to avoid complications are stressed and conclusions reached. The paper is based on experience in the Head and Neck Unit of the Royal Marsden Hospital, London, mainly since 1965. It also derives from an extensive report on 189 cases of floor of mouth cancer seen and treated at the Hospital from 1950-1974.