Editorial: Multdisciplinary Management of Oral Cancer: Diagnosis, Treatment, and Rehabilitation

Oreste Iocca^1*Camila Lopes Cardoso²Pasquale Di Maio³

• ¹University of Turin, Turin, Italy
• ²Universidade de Sao Paulo, São Paulo, Brazil
• ³Ospedale di Magenta, Magenta, Italy

The most common etiologic factors are smoking and alcohol consumption, while human papilloma virus (HPV) infection has a role especially in the etiology of oropharynx carcinoma (Lydiatt et al.).HNC most commonly spread to regional lymph nodes of the neck, with distant metastases to other organs via hematogenous routes occurring less frequently (Brands et al., Iocca et al. 2025) Treatment options consist of surgery, radiotherapy, and chemotherapy, which are typically used in combination or in sequence. Immunotherapy has emerged as a potential treatment option in both the adjuvant or neoadjuvant setting (Zhang et al.).Oral cavity carcinoma (OCC) represents a significant global public health problem (Rahman et al.).According to the most recent estimates available from the global cancer observatory (Bray et al.), it is the 16 th most common cancer worldwide with an estimated incidence of 389'846 cases and 188'438 deaths. Management of OCC is complex and a careful interplay of surgery, radiotherapy, and chemotherapy guarantees higher chances of survival and the best quality of life (QoL) after treatment. Also, perioperative care and treatment decisions must be taken in accordance with the best available scientific evidence, clinicians experience, and patients' preferences. For this reason, the focus of this research topic was on the multidisciplinary management of this elusive disease.Every new oral cancer diagnosis should be discussed on a multidisciplinary tumor board (MTB), this is important in order to take appropriate therapeutic decisions and expedite the treatment pathways.The MTB discussion should also serve as a platform where surgeons, pathologists, radiologists, radiotherapists, and supportive care specialists can discuss areas of uncertainty, whether related to diagnostic interpretation or optimal treatment strategy. The paper by Burkhardt et al. evaluated the potential benefits of pretherapeutic MTB for OCC. The study analyzed data from a group of patients which received no pretherapeutic presentation and a group which received pretherapeutic MTB discussion. The results showed that MTB presentation led to a higher adherence to national guidelines compared to the non-MTB group. Also, a tendency toward a higher 5-year survival was shown, although this was not statistically significant. On the other hand, the MTB group showed a higher diagnosis-to-treatment delay. The authors suggest that this observed delay in treatment initiation may be offset by improved coherence with the guideline. These results confirm the importance of MTB discussion in providing the best evidence-based care to OCC patients and, potentially, increasing the survival chances. physical and mental well-being. This further confirms that a holistic approach to patient care must be integrated in all multidisciplinary teams treating head and neck cancer. The study by Hoene et al. focused on an important aspect of doctor-patient relationship, namely communication. The authors proved that wearing face masks does not significantly impair perceived empathy in the context of physician-patient communication. This finding suggests that implementing a simple yet important safety measure for both healthcare personnel and patients does not compromise the quality of care.Regarding OCC treatment, surgery is the first treatment option with microvascular reconstruction is often needed after tumor ablation, usually followed by radiotherapy or chemoradiotherapy according to specific disease characteristics. Access to the best specialized care if thus fundamental in order to obtain the best chances of survival. The paper by Goodnight et al. examined geospatial analysis from various public databases in the United States. It was shown that significant regional disparities in access to head and neck specialists exist, with non-metropolitan areas and regions outside the Northeast showing notably longer travel times. Socioeconomic and demographics factors, including lower household income, lower insurance coverage, and higher median age, were associated with increased travel times. The disparity index developed by the study could serve as a tool for identifying high-need areas and guiding policy interventions. This kind of research is useful to understand how to best allocate resources, implement mobile clinics, and create incentives for improving access to specialized care.Microvascular reconstruction provides the best treatment results after ablation although this type of surgery has an unavoidable impact on the QoL. Zhao et al. examined the functional outcomes and quality of life following free fibula flap (FFF) harvest with either flexor hallucis longus (FHL) resection or its preservation. The results showed that resecting the FHL during FFF harvest produced only temporary functional and quality-of-life impairments, most of which were resolved within six months.The authors concluded that preservation of the FHL is recommended when feasible. On the other hand, its harvest remains a safe option when additional soft tissue is required. Fenske et al. studied the occurrence of osteoradionecrosis (ORN) in osseous free flaps after maxillofacial reconstruction.They concluded that osseous free flap ORN is a severe complication which often leads to total flap loss especially in patients that smoke and those who had prior reconstruction plate exposure. This outlines the importance of careful preoperative evaluation when performing reconstruction with an osseous flap in patients in which radiotherapy will be likely indicated.Neck dissection is often indicated in patients affected by OCC (Iocca et al., 2025). Sentinel lymph node biopsy (SNLB) is not widely adopted but is performed in some specialized centers. Wang et al. examined whether sentinel lymph node biopsy provides better regional control than observation in early stage maxillary squamous cell carcinoma. Results demonstrated superior regional control of SNLB patients compared to observation in patients diagnosed with cT1/2N0 maxillary OCC. Future studies will be needed to compare elective neck dissection versus SNLB. Wei et al. explored the effectiveness of ultrasound-guided microwave ablation combined with radiotherapy and chemotherapy for patients with poor performance status or those unwilling to undergo surgery. In this context, encouraging results have been demonstrated concerning the safety and minimally invasive nature of treatment for advanced tongue cancer.In conclusion, the valuable papers published in this research topic collection show that the research field regarding OCC management is dynamic and rapidly evolving, offering exciting opportunities for future developments and innovations. Once again, it has been shown that multidisciplinary efforts are fundamental to obtaining optimal care for patients afflicted by OCC. Future developments in individualized care and more refined treatment modalities will guarantee improved survival outcomes and a better quality of life results.