Oral squamous cell carcinoma (OSCC) represents the most common malignant neoplasm of the oral cavity, accounting
for approximately 90% of all oral cancers. Despite advances in treatment modalities, the 5-year survival rate has
remained relatively unchanged over the past few decades, highlighting the need for improved therapeutic strategies.
This narrative review aims to synthesize current evidence on advances in the surgical management of OSCC, examining the evolution from conventional approaches to innovative techniques, and exploring future directions in the field. We comprehensively review the pathophysiology and molecular landscape of OSCC, recent diagnostic and staging advances, conventional and minimally invasive surgical approaches including robotic-assisted surgery, and
contemporary reconstruction techniques. The literature reveals that while traditional surgical resection remains the
cornerstone of treatment, technological innovations have enabled more precise tumor removal with better functional
and aesthetic outcomes. Sentinel lymph node biopsy, transoral robotic surgery, and 3D-printed reconstruction represent significant advances that are reshaping the surgical paradigm. However, challenges remain in early detection, margin assessment, and personalized treatment approaches. The integration of molecular profiling with surgical decisionmaking holds promise for the future, potentially enabling more tailored interventions. This review underscores that multidisciplinary collaboration and continued technological innovation will be essential to improve survival outcomes and quality of life for OSCC patients.
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