The Journal of Laryngology & Otology

Review Articles

Role of surgery in the management of head and neck cancer: a contemporary view of the data in the era of organ preservation

K Hörmanna1 c1 and H Sadicka1

a1 Department of Otolaryngology, Head and Neck Surgery, University Hospital Mannheim, Germany


Objective: Review of the literature on the role of surgery in the management of head and neck cancer in the era of organ preservation.

Method: Literature search based on the essential practice guidelines set out by the US National Comprehensive Cancer Network.

Results: Despite the increasing popularity of non-surgical treatment options, the surgeon remains a key figure in the multidisciplinary head and neck cancer team, along with the radiation oncologist, the medical oncologist and the speech and swallowing therapist. Even when organ preservation is successful, early and late toxicity may cause serious complications, including laryngeal dysfunction with a ‘frozen larynx’. When organ preservation fails, salvage surgery is often associated with increased complications and reduced survival.

Conclusion: There is a definite need to apply more rigorous standards to the use of organ preservation strategies, and to re-evaluate the role of surgery in head and neck cancer treatment.

(Accepted April 25 2012)

(Online publication January 08 2013)

Key words

  • Head And Neck Neoplasms;
  • General Surgery;
  • Organ Preservation;
  • Survival


c1 Address for correspondence: Professor Karl Hörmann, Head and Chair of the Department of ORL, HNS, University Hospital of Mannheim, Theodor-Kutzer-Ufer, 68135 Mannheim, Germany Fax: +49 6213833827 E-mail:


  Professor K Hörmann was one of the 2012 JLO Visiting Professors

Presented as the Eugene N Myers International Lecture in Head and Neck Surgery, at the Annual Meeting of the American Academy of Otolaryngology, Head and Neck Surgery, 12 September 2012, San Francisco, California, USA

  Professor K Hörmann takes responsibility for the integrity of the content of the paper

Competing interests: None declared