REVIEWS   

Otorinolaringologia 2004 June;54(2):81-92

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Surgical management of advanced head and neck cancer

Bentz B. G. ¹, Kraus D. H. ²

¹ Department of Surgery Division of Otolaryngology-Head and Neck Surgery University of Utah, School of Medicine Huntsman Cancer Institute, Salt Lake City, UT, USA 2 Department of Surgery, Head and Neck Service, Memorial Sloan-Kettering Cancer Center New York, NY, USA

The intro­duc­tion of chem­o­ther­a­py to the treat­ment arma­men­tar­i­um for ­head and ­neck can­cer (H&NCa) has ­brought ­about rev­o­lu­tion­ary chang­es in the way that we ­approach ­advanced ­head and ­neck neo­plas­tic dis­ease. Yet, a ­lack of pros­pec­tive ran­dom­ized ­data to defin­i­tive­ly ­prove sur­vi­val or func­tion­al ben­e­fit ­with the use of ­these new treat­ment par­a­digms under­scores the ­fact ­that sur­gi­cal ther­a­py ­with appro­pri­ate recon­struc­tion con­tin­ues to ­play a cen­tral ­role in the treat­ment of ­advanced ­stage H&NCa. Because of ­this rap­id evo­lu­tion of ther­a­peu­tic strat­e­gies, an indi­vid­u­al ­treatment’s ­role and its inter­re­la­tion­ship ­with oth­er modal­ities ­must be con­stant­ly reeval­u­at­ed in ­order to tail­or the ­most opti­mal treat­ment ­approach to a giv­en clin­i­cal prob­lem. The pur­pose of ­this ­review arti­cle is to dis­cuss the ­present ­state of art for sur­gi­cal extir­pa­tion and recon­struc­tion for ­advanced neo­plas­tic dis­eas­es of the ­head and ­neck. These treat­ment ­options ­must con­tin­ue to be con­sid­ered main­stay ther­a­py for ­these ­patients ­until the con­tro­ver­sies of opti­mal treat­ment strat­e­gies are ade­quate­ly ­resolved.