We have previously seen a 92-year-old patient with right buccal cancer, and we are now reviewing and sharing this case in the hope that we can have a more objective understanding of the feasibility of surgical radical treatment for elderly tumor patients. Case description: This is a 92-year-old female patient who was admitted to our department on March 26, 2019 due to a “right cheek mass found for 7 months”. The patient presented with a right cheek mass the size of a peanut grain 7 months ago, and the surgery would have been relatively simple if the pathology could have been excised and locally expanded at that time. However, the local doctors considered the tumor inoperable in elderly patients, so the patient and her family gave up further treatment. But then the mass grew bigger and bigger, and it became painful and ulcerated, which seriously affected the eating and quality of life. So the patient’s children took the old man to Guangzhou for medical treatment, and many hospitals refused to hospitalize him due to his advanced age and unsatisfactory general condition. The patient’s general condition was really unsatisfactory when he came to our hospital. I remember that the patient was pushed into the consultation room by his child in a wheelchair and was quite weak. On admission, the patient was clearly conscious, mentally ill, and obviously wasted. A cauliflower-like swelling was seen on the right cheek, about 5.0×4.0 cm, with partial ulceration and bleeding on the surface; it was hard, with unclear borders and obvious tenderness, and there was no obvious adhesion between the swelling and the skin of the cheek. No obvious enlarged lymph nodes were found in the bilateral neck and submandibular area. CT findings showed that the right buccal mass invaded the right buccobuccal muscle/extra-parietal muscle/biting muscle/orbicularis oris muscle and the bone of the inferior/lateral wall of the right maxillary sinus. Inflammation of bilateral septal sinuses/right maxillary sinus. Few foci of fibrosis in the anterior segment/middle lobe of the right upper lung; few enlarged lymph nodes in the mediastinum. Pathological biopsy after admission was considered: squamous cell carcinoma of the right cheek. For such a senior tumor patient, the treatment of tumor needs to consider not only the disease itself, but also the patient’s systemic condition, which is very critical. Therefore, after admission, we improved the relevant examinations and found that the patient’s N-terminal brain natriuretic peptide precursor: 5725.Opg/ml, hemoglobin 98g/L, albumin 27.8g/L, cardiac ultrasound results showed: mitral annulus and leaflet calcification and mild regurgitation; tricuspid valve moderate regurgitation; mild pulmonary hypertension; pulmonary valve mild regurgitation. For the treatment of such an elderly and systemically unsatisfactory tumor patient, a joint multidisciplinary consultation would be helpful to develop a reasonable overall treatment plan. For this reason, I invited the ICU, cardiovascular medicine, cardiac surgery, anesthesiology, and nutrition departments to consult together to discuss the assessment of the patient’s systemic condition and the precautions needed during the perioperative period as well as strategies for dealing with various possible complications. On April 4, we performed “right buccal cancer enlargement resection + elective cervical lymphatic dissection + patch repair” for the patient. The operation was smooth and the vital signs were stable during the operation. After the operation, the patient was transferred to the ICU and then to the general ward of our department one week later. The patient developed venous thrombosis in the lower extremities after the operation, which was treated aggressively, and eventually the patient had no other complications and the area healed well. How did the patient recover after surgery? After the operation, the patient recovered very well. At the follow-up visit, the patient’s general condition was good, including eating and mental health, which was significantly better than before surgery. Both the patient and the family expressed great appreciation. It is worth mentioning that the patient’s children were very filial and stayed with her before and after hospitalization and encouraged her mother’s rehabilitation after surgery, which also shows that careful perioperative care, including spiritual support and care from family members, is also very important for the patient’s recovery. Case notes: For such elderly tumor patients, first of all, family members and patients should be fully informed and fully aware of the disease. There are always risks involved in surgery, and the risk of surgery in elderly patients increases accordingly, but multidisciplinary consultation and adequate and well-developed treatment plans will help to reduce possible complications and improve the safety and effectiveness of surgical treatment. Second, surgery is usually the primary treatment for many tumor surgeries, especially for many oral cancers. The first surgical treatment often determines the patient’s prognosis, and many elderly patients often have only one chance for surgical treatment. Therefore, for such a life-saving surgery, we surgeons must have the spirit of commitment while possessing excellent surgical skills. It is often difficult for surgeons to make qualitative improvements if they are doing routine and systemically well patients every day. For patients with complex, non-routine surgery, unsatisfactory general condition, and advanced age, a full and perfect understanding and analysis of the condition and complete planning of the treatment plan will undoubtedly help to develop a surgeon’s character. Therefore, I would like to emphasize that not all elderly oncology patients have no chance of surgery and have to give up or accept palliative treatment options. I have also recently operated on a number of elderly tumor patients in their eighties, and there is another one now in the hospital who is an 84-year-old grandmother, and surgical treatment is entirely possible through preoperative sessions with adequate evaluation and preparation.