Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-x24gv Total loading time: 0 Render date: 2024-06-08T04:41:53.010Z Has data issue: false hasContentIssue false

126 - Surgical management of head and neck cancer

Published online by Cambridge University Press:  12 January 2010

Amy Y. Chen
Affiliation:
Emory University, School of Medicine, Atlanta, GA
Michael F. Lubin
Affiliation:
Emory University, Atlanta
Robert B. Smith
Affiliation:
Emory University, Atlanta
Thomas F. Dodson
Affiliation:
Emory University, Atlanta
Nathan O. Spell
Affiliation:
Emory University, Atlanta
H. Kenneth Walker
Affiliation:
Emory University, Atlanta
Get access

Summary

Head and neck cancer or cancer of the upper aerodigestive tract is an unusual malignancy comprising only 3% of all newly diagnosed cancers in the USA. However, in many parts of the world, particularly in India and France, head and neck cancer is a major cause of death. Four sites encompass the upper aerodigestive tract: the oral cavity, oropharynx, hypopharynx, and the larynx. The oral cavity includes the lips, oral tongue, floor of the mouth, alveolar ridge, and buccal mucosa; the oropharynx comprises the base of the tongue, the lateral pharyngeal wall, and the tonsil; the hypopharynx consists of the pyriform sinus, the posterior pharyngeal wall, and the postcricoid region; and the larynx includes the epiglottis, the endolarynx, and the subglottic region. The most common pathology is that of squamous cell carcinoma encompassing greater than 90% of all tumors in the upper aerodigestive tract. Five-year survival rates have changed little in the past 30 years: Stage III and IV cancer survival rates are 40%–50% and Stage I and II rates are 70%–90%. Treatment includes chemotherapy, radiotherapy, and/or surgery.

Surgery is indicated either as definitive or as salvage treatment. Definitive methods includes glossectomy, composite resection of mandible and part of the oral cavity and/or oropharynx, and laryngectomy. Neck dissections are usually included because of the primary echelon of nodal drainage for these malignancies to be in the neck. Salvage treatment is reserved for residual disease following chemotherapy and/or radiation and may include the same procedures associated with definitive treatment.

Type
Chapter
Information
Medical Management of the Surgical Patient
A Textbook of Perioperative Medicine
, pp. 767 - 769
Publisher: Cambridge University Press
Print publication year: 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Brazilian Head and Neck Cancer Study Group. Results of a prospective trial on elective modified radical classical vs. supraomohyoid neck dissection in the management of oral squamous carcinoma. Am. J. Surg. 1998; 176: 422–427.CrossRef
Byers, R. M., Clayman, G. L., McGill, D.et al. Selective neck dissections for squamous carcinoma of the upper aerodigestive tract: patterns of regional failure. Head Neck 1999; 21: 499–505.3.0.CO;2-A>CrossRefGoogle ScholarPubMed
Johnson, J. T., Myers, E. N., Bedetti, C. D., Barnes, C. L., Schramm, V. L. Jr., & Thearle, P. B.Cervical lymph node metastases: incidence and implications of extracapsular carcinoma. Arch. Otolaryngol. 1985; 111: 534–537.CrossRefGoogle ScholarPubMed
Munro, A. J.An overview of randomized controlled trials of adjuvant chemotherapy in head and neck cancer. Br. J. Cancer 1995; 71: 83–91.CrossRefGoogle ScholarPubMed
O'Brien, C. J., Lahr, C. J., & Soong, S.Surgical treatment of early stage carcinoma of the oral tongue. Head Neck Surg. 1986; 8: 401–408.CrossRefGoogle ScholarPubMed
Pauloski, B. R., Rademaker, A. W., Logemann, J. A., & Colangelo, L. A.Speech and swallowing in irradiated and nonirradiated postsurgical oral cancer patients. Otolaryngol. Head Neck Surg. 1998; 118: 616–624.Google ScholarPubMed
Shumrick, D. A. & Quenelle, D. J.Malignant disease of the tonsillar region, retromolar trigone and buccal mucosa. Otolaryngol. Clin. Am. 1979; 12: 115–120.Google ScholarPubMed
Vokes, E. E., Kies, M. S., Haraf, D. J.et al. Concomitant chemoradiotherapy as primary therapy for locoregionally advanced head and neck cancer. J. Clin. Oncol. 2000; 18: 1652–1661.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×