Shanghai, China — A 33-year-old man diagnosed with extremely advanced tongue cancer has successfully undergone life-saving surgery at Shanghai Ninth People’s Hospital, thanks to a coordinated multidisciplinary treatment strategy that transformed an initially inoperable case into a surgical success.

The patient was diagnosed two months ago with advanced squamous cell carcinoma of the tongue (clinical stage T4aN3bM0), a highly aggressive form of oral cancer. By the time of diagnosis, the tumor had already encased the left carotid artery, placing him in a high-risk category where conventional surgery is often considered too dangerous or technically unfeasible.

His condition deteriorated rapidly when the tumor ulcerated and caused severe bleeding, prompting an emergency admission to Shanghai Ninth People’s Hospital, a leading center for oral and maxillofacial medicine in China.

Turning an “Inoperable” Case into a Surgical Opportunity

Upon reviewing the case, Professor He Yue, head of the hospital’s Oral and Maxillofacial–Head and Neck Oncology Department, immediately convened a multidisciplinary team (MDT) involving specialists from medical oncology, radiation oncology, imaging, pathology, anesthesia, and nutrition.

After comprehensive evaluation of the patient’s clinical condition, physical tolerance, and personal circumstances, the team adopted a conversion therapy approach — a strategy increasingly used in advanced cancer care worldwide. The patient first received a combination of targeted therapy, immunotherapy, and chemotherapy, with the goal of shrinking the tumor and reducing surgical risk.

The results were significant. After standardized treatment, imaging confirmed substantial tumor regression, symptoms improved markedly, and the patient met all criteria for radical surgery — breaking through what had initially been deemed an “inoperable” impasse.

Complex Surgery and Coordinated Recovery

Following a second MDT consultation to address anesthesia risks and postoperative recovery planning, surgeons performed a radical resection involving the tongue and bilateral neck. To restore function and appearance, the surgical team simultaneously carried out advanced reconstructive procedures, including an anterolateral thigh free flap and a pectoralis major myocutaneous flap, repairing tissue defects in both the tongue and neck.

The operation proceeded smoothly, with close coordination across specialties.

Postoperatively, a dedicated nursing and rehabilitation team implemented a personalized recovery plan, covering wound care, nutritional support, swallowing guidance, and functional rehabilitation. The patient achieved primary wound healing without major complications and has now been discharged from the hospital. He is scheduled to begin comprehensive postoperative therapy in the coming weeks.

A Model of Precision Cancer Care

Hospital clinicians emphasized that the case highlights the growing role of multidisciplinary, patient-centered care in managing complex head and neck cancers. By integrating systemic therapies with precise surgical timing and advanced reconstruction, teams can increasingly offer hope to patients once considered beyond surgical treatment.

“This case reflects how modern oncology is no longer about a single treatment or department,” said a member of the care team. “It’s about coordination, precision, and giving patients the best possible chance — even in the most challenging situations.”

Editor: ChenQing@ShanghaiDoctor.cn