Current surgical treatment of squamous cell carcinoma of the head and neck

Oral Oncol. 2007 Mar;43(3):213-23. doi: 10.1016/j.oraloncology.2006.04.013. Epub 2006 Sep 15.

Abstract

Historically treatment of head and neck cancers involved surgical resection followed by radiation therapy for advanced tumors. Concurrent chemoradiation therapies have shown equal survival to surgical resection with better preservation of function. However, concurrent therapy does entail significant morbidity, and recent advances have been used to minimize that morbidity. Newer tumor specific medical therapies are anticipated to be less toxic while maintaining a high degree of efficacy. For resectable cancer, transoral laser microsurgery is a new trend in surgery for complete resection of tumors with preservation of function. Advanced reconstructive techniques that allow free transfer of soft tissue and bone from all over the body improve the functional and aesthetic outcomes following major ablative surgery. With successful surgical reconstruction, dental and prosthetic rehabilitation choices are enhanced. Advances in rehabilitation of speech following removal of the larynx have improved the quality of life post-laryngectomy patients. With these newer therapies and methods of reconstruction, each patient needs to be carefully evaluated to maximize the possibility of cure and level of function, and minimize the morbidity associated with treatment. Combined chemotherapy and radiation protocols are associated with increased acute and chronic toxicities that may affect the quality of life due to the impact upon oral disease and oral function. Oral care providers must be aware of advances in cancer management and implications for patient care to effectively care for these patients.

Publication types

  • Review

MeSH terms

  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery*
  • Chemotherapy, Adjuvant / methods
  • Combined Modality Therapy / methods
  • Head and Neck Neoplasms / drug therapy
  • Head and Neck Neoplasms / radiotherapy
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Laryngeal Neoplasms / drug therapy
  • Laryngeal Neoplasms / radiotherapy
  • Laryngeal Neoplasms / surgery
  • Neck / surgery
  • Pharyngeal Neoplasms / drug therapy
  • Pharyngeal Neoplasms / radiotherapy
  • Pharyngeal Neoplasms / surgery
  • Plastic Surgery Procedures / methods
  • Radiotherapy, Adjuvant / methods
  • Salvage Therapy / methods
  • Speech
  • Surgical Flaps
  • Treatment Outcome