Surgery remains the frontline treatment for oral cancer. Factors affecting the surgical management are related to the staging of the primary disease and the presence of regional or distant metastasis. Histopathological parameters such as tumour grade, depth and pattern of invasion are of paramount importance for the extent of the surgical treatment. Surgery of the neck is evolving to more selective treatments and the concept of sentinel lymph node biopsy is gradually been established in the management of the neck for early oral cancer. Reconstruction of the defect is mainly performed with free flaps. Further refinement in the flap selection and harvesting techniques will lead to free-style flap reconstruction, minimising the morbidity of the donor site and increasing the versatility of reconstruction at the recipient site.
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