Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-18T23:34:17.687Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  08 January 2013

K Hörmann*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Mannheim, Germany
H Sadick
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Mannheim, Germany
*
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: karl.hoermann@umm.de

Abstract

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.

Type
Review Articles
Copyright
Copyright © JLO (1984) Limited 2013

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.)

Footnotes

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

References

1Jemal, A, Murray, T, Ward, E, Samuels, A, Tiwari, RC, Ghafoor, A et al. Cancer statistics, 2005. CA Cancer J Clin 2005;55:1030 (See also Erratum, CA Cancer J Clin 2005;55:259)CrossRefGoogle ScholarPubMed
2Saunders, MI, Rojas, AM. Management of cancer of the head and neck – a cocktail with your PORT? N Engl J Med 2004;350:1997–9CrossRefGoogle ScholarPubMed
3Shiboski, CH, Schmidt, BL, Jordan, RC. Tongue and tonsil carcinoma: increasing trends in the U.S. population ages 20–44 years. Cancer 2005;103:1843–9CrossRefGoogle ScholarPubMed
4Watts, SL, Brewer, EE, Fry, TL. Human papilloma virus DNA types in squamous cell carcinomas of the head and neck. Oral Surg Oral Med Oral Pathol 1991;71:701–7CrossRefGoogle Scholar
5Dimery, IW, Hong, WK. Overview of combined modality therapies for head and neck cancer. J Natl Cancer Inst 1993;85:95111CrossRefGoogle ScholarPubMed
6Vokes, EE, Weichselbaum, RR, Lippman, SM, Hong, WK. Head and neck cancer. N Engl J Med 1993;328:184–94CrossRefGoogle ScholarPubMed
7Laramore, 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;23:705–13CrossRefGoogle ScholarPubMed
8Carvalho, AL, Nishimoto, IN, Califano, JA, Kowalski, LP. Trends in incidence and prognosis for head and neck cancer in the United States: a site-specific analysis of the SEER database. Int J Cancer 2005;114:806–16CrossRefGoogle ScholarPubMed
9Gourin, CG, Johnson, JT. A contemporary review of indications for primary surgical care of patients with squamous cell carcinoma of the head and neck. Laryngoscope 2009;119:2124–34CrossRefGoogle ScholarPubMed
10Department of Veterans Affairs Laryngeal Study Group. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced larnygeal cancer. N Engl J Med 1991;324:1685–90CrossRefGoogle Scholar
11Wong, RJ, Shah, JP. The role of the head and neck surgeon in contemporary multidisciplinary treatment programs for advanced head and neck cancer. Curr Opin Otolaryngol Head Neck Surg 2010;18:7982CrossRefGoogle ScholarPubMed
12Hoffman, HT, Porter, K, Karnell, LH, Cooper, JS, Weber, RS, Langer, CJ et al. Laryngeal cancer in the United States: changes in demographics, patterns of care, and survival. Laryngoscope 2006;116:113CrossRefGoogle ScholarPubMed
13National Comprehensive Cancer Network. In: http://www.NCCN.org [17 August 2012]Google Scholar
14Sassler, AM, Esclamado, RM, Wolf, GT. Surgery after organ preservation therapy. Arch Otolaryngol Head Neck Surg 1995;121:162–5CrossRefGoogle ScholarPubMed
15Mäkitie, AA, Koivunen, P, HarriKeski-Säntti, H, Törnwall, J, Pukkila, M, Laranne, J et al. Oral tongue carcinoma and its treatment in Finland. Eur Arch Otorhinolaryngol 2007;264:263–7CrossRefGoogle ScholarPubMed
16Sessions, DG, Spector, GJ, Lenox, J, Haughey, B, Chao, C, Marks, J. Analysis of treatment results for oral tongue cancer. Laryngoscope 2002;112:616–25CrossRefGoogle ScholarPubMed
17Wolfensberger, M, Zbaeren, P, Dulguerov, P, Müller, W, Arnoiux, A, Schmid, S. Surgical treatment of early oral carcinoma – results of a prospective controlled multicenter study. Head Neck 2001;23:525–30CrossRefGoogle ScholarPubMed
18Walvekar, RR, Li, RJ, Gooding, WE, Gibson, MK, Heron, D, Johnson, JT et al. Role of surgery in limited (T1-2, N0-1) cancers of the oropharynx. Laryngoscope 2008;118:2129–34CrossRefGoogle ScholarPubMed
19O'Hara, J, MacKenzie, K. Surgical versus non-surgical management of early stage oropharyngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol 2011;268:437–42CrossRefGoogle ScholarPubMed
20Mendenhall, WM, Morris, CG, Amdur, RJ, Hinerman, RW, Malyapa, RS, Werning, JW. Definitive radiotherapy for tonsillar squamous cell carcinoma. Am J Clin Oncol 2006;29:290–7CrossRefGoogle ScholarPubMed
21Roosli, C, Tschudi, DC, Studer, G, Braun, J, Stoeckli, SJ. Outcome of patients after treatment for a squamous cell carcinoma of the oropharynx. Laryngoscope 2009;119:534–40CrossRefGoogle ScholarPubMed
22Cosmidis, A, Rame, JP, Dassonville, O. T1-T2 N0 oropharyngeal cancers treated with surgery alone. A GETTEC study. Eur Arch Otorhinolaryngol 2004;261:276–81Google Scholar
23Galati, LT, Myers, EN, Johnson, JT. Primary surgery for early SCC of the tonsil. Head Neck 2000;22:294–63.0.CO;2-9>CrossRefGoogle Scholar
24Lusinchi, A, Wibault, P, Marandas, P, Kunkler, I, Eschwege, F. Exclusive radiation therapy: the treatment of early tonsillar tumors. Int J Radiat Oncol Biol Phys 1989;17:273–7CrossRefGoogle ScholarPubMed
25Palme, CE, Gullane, PJ, Gilbert, RW. Current treatment options in squamous cell carcinoma of the oral cavity. Surg Oncol Clin N Am 2004;13:4770CrossRefGoogle ScholarPubMed
26Marur, S, Forastiere, A. Head and neck cancer: changing epidemiology, diagnosis, and treatment. Mayo Clin Proc 2008;83:489501CrossRefGoogle ScholarPubMed
27Cooper, JS, Pajak, TF, Forastiere, AA, Jacobs, J, Campbell, BH, Saxman, SB. Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 2004;350:1937–44CrossRefGoogle ScholarPubMed
28Liao, CT, Chang, JT, Wang, HM, Ng, SH, Hsueh, C, Lee, LY. Surgical outcome of T4a and resected T4b oral cavity cancer. Cancer 2006;107:337–44CrossRefGoogle ScholarPubMed
29Udoff, RA, Elam, JC, Gourin, CG. Primary surgery for oropharyngeal cancer. Otolaryngol Head Neck Surg 2010;143:644–9CrossRefGoogle ScholarPubMed
30Bernier, J, Domenge, C, Ozsahin, M, Matuszewska, K, Lefèbvre, JL, Greiner, RH. Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 2004;350:1945–52CrossRefGoogle ScholarPubMed
31Lang, S, Wollenberg, B, Dellian, M, Steuer-Vogt, MK, Schwenzer, K, Sautier, W. Clinical and epidemiological data of patients with malignomas of the head and neck [in German]. Laryngorhinootologie 2002;81:499508CrossRefGoogle ScholarPubMed
32Steiner, W, Ambrosch, P, Hess, CF, Kron, M. Organ preservation by transoral laser microsurgery in piriform sinus carcinoma. Otolaryngol Head Neck Surg 2001;124:5867CrossRefGoogle ScholarPubMed
33Takes, RP, Strojan, P, Silver, CE, Bradley, PJ, Haigentz, M Jr, Wolf, GT. Current trends in initial management of hypopharyngeal cancer: the declining use of open surgery. Head Neck 2012;34:270–81CrossRefGoogle ScholarPubMed
34Kraus, DH, Zelefsky, MJ, Brock, HA, Huo, J, Harrison, LB, Shah, JP. Combined surgery and radiation therapy for squamous cell carcinoma of the hypopharynx. Otolaryngol Head Neck Surg 1997;116:637–41CrossRefGoogle ScholarPubMed
35Bova, R, Goh, R, Poulson, M, Coman, WB. Total pharyngolaryngectomy for squamous cell carcinoma of the hypopharynx: a review. Laryngoscope 2005;115:864–9CrossRefGoogle ScholarPubMed
36Ogura, JH, Marks, JE, Freeman, RB. Results of conservation surgery for cancers of the supraglottis and pyriform sinus. Laryngoscope 1980;90:591600CrossRefGoogle ScholarPubMed
37Chevalier, D, Watelet, JB, Darras, JA, Piquet, JJ. Supraglottic hemilaryngopharyngectomy plus radiation for the treatment of early lateral margin and pyriform sinus carcinoma. Head Neck 1997;19:153.0.CO;2-A>CrossRefGoogle ScholarPubMed
38Makeieff, M, Mercante, G, Jouzdani, E, Garrel, R, Crampette, L, Guerrier, B. Supraglottic hemipharyngolaryngectomy for the treatment of T1 and T2 carcinomas of laryngeal margin and piriform sinus. Head Neck 2004;26:701–5CrossRefGoogle ScholarPubMed
39Martin, A, Jackel, MC, Christiansen, H, Mahmoodzada, M, Kron, M, Steiner, W. Organ preserving transoral laser microsurgery for cancer of the hypopharynx. Laryngoscope 2008;118:398402CrossRefGoogle ScholarPubMed
40Godballe, C, Jørgensen, K, Hansen, O, Bastholt, L. Hypopharyngeal cancer: results of treatment based on radiation therapy and salvage surgery. Laryngoscope 2002;112:834–8CrossRefGoogle ScholarPubMed
41Rabbani, A, Amdur, RJ, Mancuso, AA, Werning, JW, Kiwan, J, Morris, CG et al. Definitive radiotherapy for T1-T2 squamous cell carcinoma of pyriform sinus. Int J Radiat Oncol Biol Phys 2008;72:351–5CrossRefGoogle ScholarPubMed
42Lefebvre, JL, Chevalier, D, Luboinski, B, Kirkpatrick, A, Collette, L, Sahmoud, T. Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. tEORTC Head and Neck Cancer Cooperative Group. J Natl Cancer Inst 1996;88:890–9CrossRefGoogle ScholarPubMed
43Wei, WI. The dilemma of treating hypopharyngeal carcinoma: more or less. Arch Otolaryngol Head Neck Surg 2002;128:229–32CrossRefGoogle ScholarPubMed
44Hoffman, HT, Karnell, LH, Shah, JP, Ariyan, S, Brown, GS, Fee, WE et al. Hypopharyngeal patient care evaluation. Laryngoscope 1997;107:1005–17CrossRefGoogle ScholarPubMed
45Ho, CM, Lam, KH, Wei, WI, Yuen, PW, Lam, LK. Squamous cell carcinoma of the hypopharynx – analysis of treatment results. Head Neck 1993;15:405–12CrossRefGoogle ScholarPubMed
46Gourin, CG, Terris, DJ. Carcinoma of the hypopharynx. Surg Oncol Clin N Am 2004;13:8198CrossRefGoogle ScholarPubMed
47Arriagada, R, Eschwege, F, Cachin, Y, Richard, JM. The value of combining radiotherapy with surgery in the treatment of hypopharyngeal and laryngeal cancers. Cancer 1983;51:1819–253.0.CO;2-G>CrossRefGoogle ScholarPubMed
48Mirimanoff, RO, Wang, CC, Doppke, KP. Combined surgery and postoperative radiation therapy for advanced laryngeal and hypopharyngeal carcinomas. Int J Radiat Oncol Biol Phys 1985;11:499504CrossRefGoogle ScholarPubMed
49Zelefsky, MJ, Kraus, DH, Pfister, DG, Raben, A, Shah, JP, Strong, EW et al. Combined chemotherapy and radiotherapy versus surgery and postoperative radiotherapy for advanced hypopharyngeal cancer. Head Neck 1996;18:405–113.0.CO;2-9>CrossRefGoogle ScholarPubMed
50Adelstein, DJ, Saxton, JP, Lavertu, PI, Tuason, L, Wood, BG, Wanamaker, JR et al. A phase III randomized trial comparing concurrent chemotherapy and radiotherapy with radiotherapy alone in resectable stage III and IV squamous cell head and neck cancer: preliminary results. Head Neck 1997;19:567–753.0.CO;2-5>CrossRefGoogle ScholarPubMed
51Samant, S, Kumar, P, Wan, J, Hanchett, C, Vieira, F, Murry, T et al. Concomitant radiation therapy and targeted cisplatin chemotherapy for the treatment of advanced pyriform sinus carcinoma: disease control and preservation of organ function. Head Neck 1999;21:5956013.0.CO;2-J>CrossRefGoogle ScholarPubMed
52Lee, MS, Ho, H-C, Hsiao, S-H, Hwang, J-H, Lee, C-C, Hung, S-K. Treatment results and prognostic factors in locally advanced hypopharyngeal cancer. Acta Otolaryngol 2008;128:103–9CrossRefGoogle ScholarPubMed
53Pearson, BW, DeSanto, LW, Olsen, KD, Salassa, JR. Results of near-total laryngectomy. Ann Otol Rhinol Laryngol 1998;107:820–5CrossRefGoogle ScholarPubMed
54Ambrosch, P, Fazal, A. Functional organ preservation in laryngeal and hypopharyngeal cancer [in German]. Laryngorhinootologie 2011;90(suppl 1):S83109CrossRefGoogle ScholarPubMed
55Eckel, HE. Local recurrences following transoral laser surgery for early glottic carcinoma: frequency, management, and outcome. Ann Otol Rhinol Laryngol 2001;110:715CrossRefGoogle ScholarPubMed
56Eckel, HE, Thumfart, WF, Jungehülsing, M, Sittel, C, Stennert, E. Transoral laser surgery for early glottic carcinoma. Eur Arch Otorhinolaryngol 2000;257:221–6CrossRefGoogle ScholarPubMed
57Ambrosch, P, Rödel, R, Kron, M, Steiner, W. The transoral laser microsurgery of laryngeal carcinomas. A retrospective study of 657 cases [in German]. Onkologe 2001;7:505–12CrossRefGoogle Scholar
58Motta, G, Esposito, E, Motta, S, Tartaro, G, Testa, D. CO2 laser surgery in the treatment of glottic cancer. Head Neck 2005;27:566–74CrossRefGoogle ScholarPubMed
59Sjögren, EV, van Rossum, MA, Langeveld, TPM, Voerman, MS, van de Kamp, VAH, Friebel, MOW et al. Voice outcome in T1a midcord glottic carcinoma. Arch Otolaryngol Head Neck Surg 2008;134:965–72CrossRefGoogle ScholarPubMed
60Peretti, G, Piazza, C, Cocco, D, De Benedetto, L, Del Bon, F, Redaelli De Zinis, LO et al. Transoral CO(2) laser treatment for T(is)-T(3) glottic cancer: the University of Brescia experience on 595 patients. Head Neck 2010;32:977–83CrossRefGoogle Scholar
61Mendenhall, WM, Amdur, RJ, Morris, CG, Hinerman, RW. T1-T2N0 squamous cell carcinoma of the glottic larynx treated with radiation therapy. J Clin Oncol 2001;19:4029–36CrossRefGoogle ScholarPubMed
62Johansen, LV, Grau, C, Overgaard, J. Glottic carcinoma – patterns of failure and salvage treatment after curative radiotherapy in 861 consecutive patients. Radiother Oncol 2002;63:257–67CrossRefGoogle ScholarPubMed
63Smee, RI, Meagher, NS, Williams, JR, Broadley, K, Bridger, GP. Role of radiotherapy in early glottic carcinoma. Head Neck 2010;32:850–9CrossRefGoogle ScholarPubMed
64Forastiere, AA, Goepfert, H, Maor, M, Pajak, TF, Weber, R, Morrison, W et al. Concurrent chemotherapy and radiation for organ preservation in advanced laryngeal cancer. N Engl J Med 2003;349:2091–8CrossRefGoogle Scholar
65Weber, RS, Berkey, BA, Forastiere, A, Cooper, J, Maor, M, Goepfert, H et al. Outcome of salvage total laryngectomy following organ preservation therapy: the Radiation Therapy Oncology Group trial 91-11. Arch Otolaryngol Head Neck Surg 2003;129:44–9CrossRefGoogle ScholarPubMed
66American Society of Clinical Oncology, Pfister, DG, Laurie, SA, Weinstein, GS, Mendenhall, WM, Adelstein, DJ, Ang, KK et al. American Society of Clinical Oncology clinical practice guideline for the use of larynx-preservation strategies in the treatment of laryngeal cancer. J Clin Oncol 2006;24:3693–704CrossRefGoogle Scholar
67Trotti, A, Bellm, LA, Epstein, JB, Frame, D, Fuchs, HJ, Gwede, CK et al. Mucositis incidence, severity and associated outcomes in patients with head and neck cancer receiving radiotherapy with or without chemotherapy: a systematic literature review. Radiother Oncol 2003;66:253–62CrossRefGoogle ScholarPubMed
68Machtay, M, Moughan, J, Trotti, A, Garden, AS, Weber, RS, Cooper, JS. Factors associated with severe late toxicity after concurrent chemoradiation for locally advanced head and neck cancer: an RTOG analysis. J Clin Oncol 2008;26:3582–9CrossRefGoogle ScholarPubMed