eMedicine Specialties > Plastic Surgery > Head/Neck

Head and Neck Cancer - Resection and Neck Dissection: Follow-up

Author: Sanford Dubner, MD, Assistant Clinical Professor, Department of Surgery, Long Island Jewish Medical Center, Albert Einstein College of Medicine
Coauthor(s): Samuel T Ostrower, MD, Staff Physician, Department of Otorhinolaryngology, Albert Einstein College of Medicine
Contributor Information and Disclosures

Updated: Apr 3, 2008

Outcome and Prognosis

Patients with squamous cell carcinoma should not be deemed unsalvageable, since many live normal, productive lives after treatment of head and neck malignancies, with minimal morbidity and mortality.

The prognosis following treatment for a squamous cell carcinoma depends on the tumor stage. Patients with earlier (stage I) malignancies can have a cure rate in excess of 90%, depending on the site of the tumor. Even those with more advanced tumors (stage IV) can have cure rates in excess of 50%. This is attributed to several factors, including combined therapy (adjuvant radiotherapy, chemotherapy) and the fact that tumors can be determined as stage IV because of the extent of the primary tumor or the extent of nodal disease. A small primary tumor with advanced regional nodal disease can be stage IV, as can a large primary tumor with no nodal disease. These situations are disparate; nevertheless, the current staging system has some limitations, and therefore these 2 vastly different situations are staged similarly. Thus, they are considered similarly in various retrospective studies on clinical outcomes, even if they are treated differently or respond differently to treatment.

Future and Controversies

Future research must address several issues. These include improved methods of administering radiation therapy, whether fractionated daily or by other techniques, including brachytherapy. Newer forms of chemotherapeutic agents need to be addressed in controlled randomized clinical trials. Other techniques for prevention of head and neck malignancies are being studied, including education and chemoprevention. Lastly, gene therapy may hold potential for future research and treatment.

 


More on Head and Neck Cancer - Resection and Neck Dissection

Overview: Head and Neck Cancer - Resection and Neck Dissection
Workup: Head and Neck Cancer - Resection and Neck Dissection
Treatment: Head and Neck Cancer - Resection and Neck Dissection
Follow-up: Head and Neck Cancer - Resection and Neck Dissection
Multimedia: Head and Neck Cancer - Resection and Neck Dissection
References
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References

  1. Bocca E, Pignataro O, Sasaki CT. Functional neck dissection. A description of operative technique. Arch Otolaryngol. Sep 1980;106(9):524-7. [Medline].

  2. Correa AJ, Burkey BB. Current options in management of head and neck cancer patients. Med Clin North Am. Jan 1999;83(1):235-46, xi. [Medline].

  3. Bernier J, Cooper JS, Pajak TF, van Glabbeke M, Bourhis J, Forastiere A, et al. Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (# 9501). Head Neck. Oct 2005;27(10):843-50. [Medline].

  4. Candela FC, Kothari K, Shah JP. Patterns of cervical node metastases from squamous carcinoma of the oropharynx and hypopharynx. Head Neck. May-Jun 1990;12(3):197-203. [Medline].

  5. Fee WE, Goepfert H, Johns ME. Proceedings of the Second International Conference on Head and Neck Cancer. Head and Neck Cancer. 1990;2.

  6. Kramer S, Gelber RD, Snow JB, Marcial VA, Lowry LD, Davis LW, et al. Combined radiation therapy and surgery in the management of advanced head and neck cancer: final report of study 73-03 of the Radiation Therapy Oncology Group. Head Neck Surg. Sep-Oct 1987;10(1):19-30. [Medline].

  7. Laramore GE, Scott CB, al-Sarraf M, Haselow RE, Ervin TJ, Wheeler R, et al. Adjuvant chemotherapy for resectable squamous cell carcinomas of the head and neck: report on Intergroup Study 0034. Int J Radiat Oncol Biol Phys. 1992;23(4):705-13. [Medline].

  8. O'Brien CJ. A selective approach to neck dissection for mucosal squamous cell carcinoma. Aust N Z J Surg. Apr 1994;64(4):236-41. [Medline].

  9. Robbins KT. Indications for selective neck dissection: when, how, and why. Oncology (Williston Park). Oct 2000;14(10):1455-64; discussion 1467-9. [Medline].

  10. Shah JP. Patterns of cervical lymph node metastasis from squamous carcinomas of the upper aerodigestive tract. Am J Surg. Oct 1990;160(4):405-9. [Medline].

  11. Shah JP, Medina JE, Shaha AR, Schantz SP, Marti JR. Cervical lymph node metastasis. Curr Probl Surg. Mar 1993;30(3):1-335. [Medline].

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Further Reading

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Keywords

head and neck cancer, head cancer, neck cancer, carcinoma of the head and neck, primary carcinoma of the head and neck, radical neck dissection, squamous cell carcinoma, cancers of the oral cavity, cancer of the oropharynx, cancer of the larynx, modified radical neck dissection, extended radical neck dissection, elective neck dissections, supraomohyoid neck dissection, anterior compartment neck dissection, posterolateral neck dissection, lateral neck dissection

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Contributor Information and Disclosures

Author

Sanford Dubner, MD, Assistant Clinical Professor, Department of Surgery, Long Island Jewish Medical Center, Albert Einstein College of Medicine
Sanford Dubner, MD is a member of the following medical societies: American College of Surgeons, American Head and Neck Society, American Society of Plastic and Reconstructive Surgery, and New York Head and Neck Society
Disclosure: Nothing to disclose.

Coauthor(s)

Samuel T Ostrower, MD, Staff Physician, Department of Otorhinolaryngology, Albert Einstein College of Medicine
Samuel T Ostrower, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Otolaryngology-Head and Neck Surgery
Disclosure: Nothing to disclose.

Medical Editor

Lawrence Ketch, MD, FAAP, FACS, Head, Program Director, Associate Professor, Department of Surgery, Division of Plastic Surgery, University of Colorado Health Sciences Center; Chief, Pediatric Plastic, The Children's Hospital of Denver
Lawrence Ketch, MD, FAAP, FACS is a member of the following medical societies: American Academy of Pediatrics, American Association for Hand Surgery, American Association of Plastic Surgeons, American Burn Association, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Society for Surgery of the Hand, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Plastic Surgery Research Council
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Jaime R Garza, MD, DDS, FACS, Consulting Staff, Private Practice
Jaime R Garza, MD, DDS, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Medical Association, American Society for Aesthetic Plastic Surgery, American Society of Maxillofacial Surgeons, Texas Medical Association, and Texas Society of Plastic Surgeons
Disclosure: Allergan Honoraria Consulting

CME Editor

Nicolas (Nick) G Slenkovich, MD, Director, Colorado Plastic Surgery Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Al Aly, MD, FACS, Consulting Surgeon, Iowa City Plastic Surgery
Disclosure: Ethicon  Consulting fee Consulting; QMP Royalty Book royalty; Insorb Stapler Consulting fee Consulting; Insorb Stapler Ownership interest None; Medicis Intellectual property rights None

 
 
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