Eagles eye for exploration: Field cancerization - a surgeons dilemma

"Field cancerization" was introduced in 1953 to describe histologically abnormal tissues surrounding oral squamous cell carcinoma, particularly in the upper aerodigestive tract, likely related to exposure to carcinogens. Concept now refers to multiple local and distant primary tumors within the upper aerodigestive tract, along with oral premalignant lesions. Tobacco and alcohol are independent risk factors, but when combined, they have a synergistic effect. Earliest lesions are often undetectable by clinical and histologic examination; careful surveillance can detect most tumors in their intraepithelial and microinvasive stage. Early detection improves long-term survival, although multiple resections are often necessary.