Treatment of stage I carcinoma of the anterior floor of the mouth.

A retrospective study of 27 patients treated for stage I squamous cell carcinoma of the floor of the mouth was performed to assess the effectiveness of therapy. Of these patients, 23 (85%) underwent surgical therapy. Four patients (15%) were treated with radiation therapy alone, and three (11%) underwent combined surgery and radiation treatment. Initial treatment failed in seven patients (26%), and further therapy was curative in only four of seven. This small study suggests that stage I floor-of-the-mouth squamous cell carcinoma is not an easy lesion to cure. Other studies support these data. A three-dimensional monobloc resection with a 2-cm margin, including resection of the submandibular glands, is advocated. Toluidine blue O mucosal staining and Mohs' chemosurgery are helpful adjuncts in determining the tumor margins.