[Type-oriented surgery of oral cancer based on its clinical staging and histological grading].

Type-oriented surgery for oral cancer according to its clinical staging and histological grading were applied for a total of 204 cases of oral squamous cell carcinoma. These cases were classified not only by staging (St.) into 111 at St. I, II and 93 at St. III, IV, but also by grading (Gr.) into 33 of Gr. 1, 80 of Gr. 2, 69 of Gr. 3 and 22 of Gr. 4 with a total points system consisting of differentiation, mitosis, nuclear atypism, mode of invasion and lymphocytic infiltration. The four operation methods used and their indication were local excision for St. I, II + Gr. 1 in 33 cases, partial resection for St. I, II + Gr. 2, 3 and St. III, IV + Gr. 1, 2 in 115 cases, composite operation for St. I - IV + Gr. 3, 4 in 52 cases and wide resection for St. IV + Gr. 2, 3 in only 4 cases, resulting in observed survival rates of 28/30 (93.3%), 85/106(80.1%), 30/48 (62.5%) and 3/3 (100%), respectively. The cumulative survival rate estimated by staging was 86.7% for St. I, II and 77.6% for St. III, IV. Among these, cases with a high grade of histological malignancy (Gr. 4) at any clinical stage had the most unfavorable survival rate, 34.7%. Therefore, it should be emphasized that composite operation with wide local excision is necessary for such patients in order to obtain a better prognosis.