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CA LIDAH

Definisi
• Karsinoma rongga mulut : kanker yang berasal dari
epitel yang melapisi mukosa rongga mulut dan
organ-organ rongga mulut dan kelenjar salivarius.
• Yang termasuk :
– Anterior → tepi vermilion
– Posterior → Arcus pharyngeus anterior, papilla
circumvalatae, uvula, arcus
glossopalatini
– Superior → Palatum, ginggiva maxilla
– Inferior →Dasar mulut & lidah, ginggiva mandibula
– Lateral → Mukosa buccal

Arrangoiz, R. et al. (2018) ‘Oral Tongue Cancer: Literature Review and Current Management’, Cancer Reports and Reviews, 2(3).
Manuaba TW. 2010. Panduan Penatalaksanaan Kanker Solid. Peraboi.
Anatomi Lidah

Wong, T. S. C. and Wiesenfeld, D. (2018) ‘Oral Cancer’, Australian Dental Journal, 63, pp. S91–S99.
Etiologi
• Tembakau
• Alkohol
• Iritasi kronik
• Defisiensi nutrisi (Vitamin A, C, E)
• Paparan UV

Arrangoiz, R. et al. (2018) ‘Oral Tongue Cancer: Literature Review and Current Management’, Cancer Reports and Reviews, 2(3).
Borle Rm. 2014. Textbook Of Oral And Maxillofacial Surgery. Jaypee Brothers Medical Publishers (P) Ltd.
Katoch VM. 2014. consensus Document for Management of Tongue Cancer. Indian Council of Medical Research, Ansari Nagar of New Delhi.
Anamnesis
• Nyeri
• Sulit menelan
• Gangguan bicara
• Kebiasaan
• Riwayat pengobatan
• Riwayat kanker sebelumnya

Arrangoiz, R. et al. (2018) ‘Oral Tongue Cancer: Literature Review and Current Management’, Cancer Reports and Reviews, 2(3).
Katoch VM. 2014. consensus Document for Management of Tongue Cancer. Indian Council of Medical Research, Ansari Nagar of New Delhi.
Pemeriksaan Fisik
• Ukuran tumor
• Lokasi
• Perluasan tumor :
– Posterior : dasar lidah, vallecula, tonsil
– Lateral : hubungan dengan garis tengah, mandibula,
hyoid
• Paralisis n. hypoglossus
• Pembengkakan KGB cervical

Arrangoiz, R. et al. (2018) ‘Oral Tongue Cancer: Literature Review and Current Management’, Cancer Reports and Reviews, 2(3).
Chaubal, T. and Dixit, M. (2011) ‘Ankyloglossia and its management’, Journal of Indian Society of Periodontology, 15(3), p. 270.
Katoch VM. 2014. consensus Document for Management of Tongue Cancer. Indian Council of Medical Research, Ansari Nagar of New Delhi.
Diagnostik
• FNAB
• Biopsi
• Teknik Molekuler (tidak banyak digunakan)

Katoch VM. 2014. consensus Document for Management of Tongue Cancer. Indian Council of Medical Research, Ansari Nagar of New
Delhi.
Pemeriksaan Radiologi
• OPG
• USG colli
• CT Scan
• MRI
• PET scan

Katoch VM. 2014. consensus Document for Management of Tongue Cancer. Indian Council of Medical Research, Ansari Nagar of New
Delhi.
Staging

Metastasis M0 Tidak terdapat metstasis


M1 Terdapat metastasis jauh

Arrangoiz, R. et al. (2018) ‘Oral Tongue Cancer: Literature Review and Current Management’, Cancer Reports and Reviews, 2(3).
NCCN Guidelines (2019) ‘Head and neck cancers statistics’, Cancer Research UK.
Arrangoiz, R. et al. (2018) ‘Oral Tongue Cancer: Literature Review and Current Management’, Cancer Reports and Reviews, 2(3).
NCCN Guidelines (2019) ‘Head and neck cancers statistics’, Cancer Research UK.
Prinsip Pengobatan
• Early stage disease (Stage I & II) :
– Modalitas terapi tunggal (pembedahan atau
radioterapi)
– Diutamakan pembedahan
• Advanced stage disease (Stage III & IV) :
– Modalitas terapi kombinasi
– Pembedahan, radioterapi/kemoterapi

Katoch VM. 2014. consensus Document for Management of Tongue Cancer. Indian Council of Medical Research, Ansari Nagar of New
Delhi.
Operasi
• Approach pembedahan pada KRM:
 peroral
 mandibulektomi
 lower cheek flap
 visor flap
 upper cheek flap

Manuaba TW. 2010. Panduan Penatalaksanaan


Kanker Solid. Peraboi.
Approach Diseksi KGB Leher

Manuaba TW. 2010. Panduan Penatalaksanaan Kanker Solid. Peraboi.


Komplikasi
• Perdarahan
• infeksi
• Kesulitan bernapas
• Kesulitan makan

Arrangoiz, R. et al. (2018) ‘Oral Tongue Cancer: Literature Review and Current Management’, Cancer Reports and Reviews, 2(3).
Manuaba TW. 2010. Panduan Penatalaksanaan Kanker Solid. Peraboi.
Follow Up
• Setiap 2-3 bulan pada 2 tahun pertama
• Setiap 3-4 bulan pada tahun ke 3
• Setiap 6 bulan pada tahun ke 4-5
• Setiap tahun, pada tahun-tahun berikutnya
• Setiap follow up dilakukan pemeriksaan
kepala-leher, loko-regional, tumor sekunder,
dan sekuele terapi. Investigasi jika ada indikasi
• Rö thorax
Arrangoiz, R. et al. (2018) ‘Oral Tongue Cancer: Literature Review and Current Management’, Cancer Reports and Reviews, 2(3).
Katoch VM. 2014. consensus Document for Management of Tongue Cancer. Indian Council of Medical Research, Ansari Nagar of New Delhi.
Daftar Pustaka
• Arrangoiz, R. et al. (2018) ‘Oral Tongue Cancer: Literature Review and Current Management’, Cancer
Reports and Reviews, 2(3).
• Arya, S., Chaukar, D., & Pai, P. (2012). Imaging in oral cancers. Indian Journal of Radiology and Imaging,
22(3), 195.
• Barret, J. P. and Roodenburg, J. L. (2017) ‘Functional rehabilitation in advanced intraoral cancer’,
International Journal of Surgery Oncology, 2(2), p. e10.
• Borle Rm. 2014. Textbook Of Oral And Maxillofacial Surgery. Jaypee Brothers Medical Publishers (P) Ltd.
• Hui, A. C., Tsui, I. W. and Chan, D. P. (2009) ‘Hypoglossal nerve palsy’, Hong Kong medical journal =
Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 15(October), pp. 249–250.
• Katoch VM. 2014. consensus Document for Management of Tongue Cancer. Indian Council of Medical
Research, Ansari Nagar of New Delhi.
• Langdon J, Patel M, Et Al. 2011. Operative Oral And Maxillofacial Surgery. Hodder Arnold An Hachette UK
Company.
• Manuaba TW. 2010. Panduan Penatalaksanaan Kanker Solid. Peraboi.
• NCCN Guidelines (2019) ‘Head and neck cancers statistics’, Cancer Research UK.
• Rivera, C. and Venegas, B. (2014) ‘Histological and molecular aspects of oral squamous cell carcinoma’,
Oncology Letters, 8(1), pp. 7–11.
• Pałasz, P. et al. (2017) ‘Contemporary Diagnostic Imaging of Oral Squamous Cell Carcinoma – A Review of
Literature’, Polish Journal of Radiology, 82, pp. 193–202.
• Wong, T. S. C. and Wiesenfeld, D. (2018) ‘Oral Cancer’, Australian Dental Journal, 63, pp. S91–S99