Surgery for Oral Cancers

Buccal mucosa composite resection:

Cancers of the oral cavity especially of the cheek ( buccal mucosa) is common in the Indian Subcontinent due to the peculiar habit of chewing tobacco. Cancers of this region are collectively called the gingivobuccal complex cancers comprising of the buccal mucosa, jaw bone ( mandible) and the retromolar trigone ( area behind the last molar tooth). These cancers have a propensity to spread to the regional lymph nodes ( lymph nodes in the neck). Management of these cancers involves appropriate investigations to confirm the daignosis as well as stage of the cancer. Treatment is essentially surgical extirpation with adequate margins ( circumferential) as well as dissection of the lymph nodes.

Since surgery in this region can have potential functional compromise on swallowing, speech as well as cosmesis ( when the jaw bone and large buccal cancers). Hence optimum reconstruction is equally important.

Dr. Mitali Dandekar Lall with her robust specialty training in both extirpative as well as reconstructive techniques with microvascular anastomosis ensures she gives best outcomes to her patients. Additionally, working in a team comprising of a reconstructive surgeon, nuclear medicine specialist, radiation, medical oncologist as well as physio and rehabilitation therapist further enhances her outcomes by delivering comprehensive cancer care.

She has contributed to literature pertinent to this subject as follows:

1. D’Cruz AK, Vaish R, Kapre N, Dandekar M, Gupta S, Hawaldar R, Agarwal JP, Pantvaidya G, Chaukar D, Deshmukh A, Kane S, Arya S, Ghosh-Laskar S, Chaturvedi P, Pai P, Nair S, Nair D, Badwe R; Head and Neck Disease Management Group. Elective versus Therapeutic Neck Dissection in Node-Negative Oral Cancer.N Engl J Med. 2015;373(6):521-9. PMID: 26027881. Citations: over 200. Presented at the ‘ Plenary ‘ session of ASCO 2015.

2. Chaukar D, Dandekar M, Kane S, Arya S, Purandare N, Rangarajan V, Deshmukh A, Pai P, Chaturvedi P, D’Cruz A.Relative value of ultrasound, computed tomography and positron emission tomography imaging in the clinically node-negative neck in oral cancer. Asia Pac J Clin Oncol. 2016;12(2):e332-8. PMID: 25131685.

Was selected as the Best Indian publication ( 2^nd position) in the FHNO conference 2017.

3. D’Cruz AK, Dandekar MR. Elective versus therapeutic neck dissection in the clinically node negative neck in early oral cavity cancers: do we have the answer yet? Oral Oncol. 2011;47(9):780-2. PMID: 21727024.

4. Dandekar M, Chaukar D, Kane S, Juvekar S, D’Cruz A. Intracapsular Carcinoma ex Pleomorphic Adenoma in the Buccal Space: Management Dilemma. International Journal of Head & Neck Surgery 2010;1(1):21-24.

5. Chaukar D, Purandare N, Dandekar M, Kane S, Arya S, Dcruz A. O24. Mandibular Involvement in gingivobuccal complex cancers: Preoperative assessment and study of pattern of invasion. Oral Oncol 2011;47, S36.

6. Vaish R, Dandekar M, Agarwal JP, Prabhash K, D’Cruz AK. Oral Cavity. UICC Manual of Clinical Oncology, 9, 524-541.

7. Chaukar DA, Dandekar M. Surgical Resection of Cancer of the Buccal Mucosa. Open Access Atlas of Otolaryngology Head Neck Operative Surgery. Licenced under a Creative Commons Attribution- Non – Commercial 3.0 Unported Licence. Ed Johan Fagan.

8. D’Cruz A, Vaish R, Gupta S, Arya S, Hawaldar RW, Shah S, Dandekar M, Chaukar D, Pantvaidya G, Chaturvedi P, Pai PS, Deshmukh A, Kane S, Nair D, Nair SV, Ghosh SL, Agarwal J. Does addition of neck ultrasonography to physical examintion , in follow-up of patients with early stage, clinically node negative oral cancers, influence outcome? A randomized control trial ( RCT). J Clin Oncol 2016;34(suppl;abstr 6020).

9. Dandekar M. Quality of Life Assessment after Oral Cancer Treatment. Abstract in National Seminar on Sarve Bhawantu Sukhinah, Revisiting Paradigms of Wellness, an Interdisciplinary Perspective, April 2017.

10. Topic: Mandibular Assessment in Gingivobuccal Complex Cancers and routes of tumour entry. “ Best Clinical Paper” Award at the International Federation of Head & Neck Oncologic Societies ( IFHNOS)/ Foundation for Head and Neck Oncology ( FHNO) conference 2012.

Surgery for tongue cancer:

Cancers of the oral cavity is common in the Indian Subcontinent due to the peculiar habit of chewing tobacco. Tongue cancers have a propensity to spread to the regional lymph nodes ( lymph nodes in the neck). Management of these cancers involves appropriate investigations to confirm the daignosis as well as stage of the cancer. Treatment is essentially surgical extirpation with adequate margins ( circumferential) as well as dissection of the lymph nodes.

Since surgery in this region can have potential functional compromise on swallowing and speech, optimum reconstruction is paramount.

She has contributed to literature pertinent to this subject as follows:

Was selected as the Best Indian publication ( 2^nd position) in the FHNO conference 2017.

4. Vaish R, Dandekar M, Agarwal JP, Prabhash K, D’Cruz AK. Oral Cavity. UICC Manual of Clinical Oncology, 9, 524-541.

5. D’Cruz A, Vaish R, Gupta S, Arya S, Hawaldar RW, Shah S, Dandekar M, Chaukar D, Pantvaidya G, Chaturvedi P, Pai PS, Deshmukh A, Kane S, Nair D, Nair SV, Ghosh SL, Agarwal J. Does addition of neck ultrasonography to physical examintion , in follow-up of patients with early stage, clinically node negative oral cancers, influence outcome? A randomized control trial ( RCT). J Clin Oncol 2016;34(suppl;abstr 6020).

6. Dandekar M. Quality of Life Assessment after Oral Cancer Treatment. Abstract in National Seminar on Sarve Bhawantu Sukhinah, Revisiting Paradigms of Wellness, an Interdisciplinary Perspective, April 2017.