Inoperability criteria of ca oral cavity

Q) Inoperability criteria in ca oral cavity is  ( MCH Onco 2020) 

a) Pterygoid plate involvement

b) Tooth socket involvement

c) Cheek involvement


Ans a) Pterygoid

T4b in oral cancer is Very advanced local disease.

Tumor invades masticator space, pterygoid plates, or skull base and/or encases internal carotid artery, skull base and/or encases the internal carotid artery.

Note: Superficial erosion alone of bone/tooth socket by gingival primary is not sufficient to classify as T4

Tumour involvement of the following structures are considered technically unresectable

Erosion of pterygoid plates, sphenoid bone, widening of foramen ovale

Extension to superior nasopharynx or deep extension into Eustachian tube or lateral nasopharyngeal wall

Encasement of internal carotid artery, defined radiologically as tumor surrounding the carotids> 270 degrees.

Involvement of mediastinal structures

Involvement of prevertebral fascia or cervical vertebrae

Ref is here