TONGUE CANCER Management of the neck in early stage oral cavity cancer, including the oral tongue, has been discussed above; however, consideration for elective management of the node-negative neck should be made in all instances. When performing surgical excision of the primary tumour, a 1 cm margin in all planes should be attempted in seeking a complete excision with pathologically clear (>5mm) margins. Resection resulting in paial or hemiglossectomy can be performed with either a cutting diathermy or laser if available. Advanced tumours (T3 and T4) often encroach upon the floor of the mouth and, occasionally, the mandible. In these circumstances a resection of the tongue and floor of the mouth and mandible is required. T4 tumours of the oral tongue may cross the midline, for which (sub)total glossectomy is the only option to achieve adequate tumour clearance. Decisions regarding elective neck dissections on the contralateral side will be dictated by radiological and clinical findings, in paicular proximity of the tumour to the midline. Ref: Bailey and love 27th edition Pgno : 769