_tumours of the oral cavity types 的口腔恶性肿瘤及类型课件

Malignant Tumours of the Malignant Tumours of the Oral CavityOral Cavity Types or multiple ipsilateral 6 cm in greatest dimension; or multiple ipsilateral positive lymph nodes none more than 6 cmpositive lymph nodes none more than 6 cm in diameter in diameter N2aN2a Metastasis in single ipsilateral lymph node Metastasis in single ipsilateral lymph node more than 3 cm but not more than 6 cm in more than 3 cm but not more than 6 cm in greatest dimensiongreatest dimension N2bN2b Metastasis in multiple ipsilateral lymph Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest nodes, none more than 6 cm in greatest dimensiondimension N3N3 Metastasis in a lymph node more than 6 cm in Metastasis in a lymph node more than 6 cm in greatest dimension(N3a), bliateral nodes (N3b) greatest dimension(N3a), bliateral nodes (N3b) contralateral node or nodes (N3c).contralateral node or nodes (N3c). MX MX Presence of distant metastasis Presence of distant metastasis cannot be assessedcannot be assessed M0M0 No distant metastasis No distant metastasis M1M1 Distant metastasis Distant metastasis Staging Staging n n Stage I Stage I T1 N0 M0 85%T1 N0 M0 85% n n Stage II Stage II T2 N0 M0 66%T2 N0 M0 66% n n Stage III Stage III T3 N0 M0 41%T3 N0 M0 41% Any T1, T2, T3 + N1 M0 Any T1, T2, T3 + N1 M0 n n Stage IV 9%Stage IV 9% Any T4Any T4 Any N2 or N3 Any N2 or N3 Any M1 Any M1 5yr survival5yr survival HEAD AND NECK CANCER HEAD AND NECK CANCER PREVENTION PREVENTION n n The most important and well known are the consumption of The most important and well known are the consumption of tobacco and alcohol and it is theoretically possible to tobacco and alcohol and it is theoretically possible to prevent a significant number of head and neck cancers if prevent a significant number of head and neck cancers if these risk factors, in particular tobacco consumption, were these risk factors, in particular tobacco consumption, were eliminated although increasing numbers of young patients eliminated although increasing numbers of young patients presenting with head and neck cancer have not been presenting with head and neck cancer have not been exposed to these risk factors. exposed to these risk factors. n n Early detection of head and neck cancer could reduce Early detection of head and neck cancer could reduce morbidity and may reduce mortality and forms an morbidity and may reduce mortality and forms an important part of these guidelines. There is a need for more important part of these guidelines. There is a need for more public education and awareness of early symptoms of head public education and awareness of early symptoms of head and neck cancer (for example Oral Cancer Awareness and neck cancer (for example Oral Cancer Awareness Week, October 1995, BAOMS, and the importance of an Week, October 1995, BAOMS, and the importance of an early diagnosis of hoarse voice and persistent oral ulcers early diagnosis of hoarse voice and persistent oral ulcers n n Opportunistic screening by primary clinicians and workers is Opportunistic screening by primary clinicians and workers is important, as is targeted screening of high risk groups. For important, as is targeted screening of high risk groups. For example, appropriately trained dentists working in the example, appropriately trained dentists working in the general dental services could form a near ideal screening general dental services could form a near ideal screening service for cancers and potentially cancerous lesions arising service for cancers and potentially cancerous lesions arising in the oral cavity. in the oral cavity. n n Research is needed into education for early detection, Research is needed into education for early detection, causative causative factors (other than known factors) eg. HPV, imaging for factors (other than known factors) eg. HPV, imaging for accurate staging and the possibility and effectiveness of accurate staging and the possibility and effectiveness of new treatment modalities new treatment modalities n n Because of the particularly distressing nature of head and Because of the particularly distre