[Current trends in diagnosis and treatment head and neck cancer].
Prognosis of head and neck squamous cell carcinomas (HNSCC) is partly determined by lymph nodes metastases. Contemporary imaging provides detection of adenopathies but remains unable to detect infracentimetric micrometastatic nodes. Topographical classification according to Robbins allows for better treatment through proper definition of impaired neck areas. The high rate of node metastases in HNSCC indicates systematic treatment of the neck in most localizations. Several neck dissection techniques are available with wide acceptation of elective functional neck dissections. Improvement of detection of node metastases and better selection of neck sites for treatment are eventual direction of progress. In neck carcinoma with unknown primary, search of primary should address first head and neck area and upper aero-digestive tract. Differential diagnosis are glomic tumour, congenital cyst and other causes of lymph node disease
Lacau St Guily
Jean Lacau
JL
Service d'ORL et chirurgie cervico-faciale, hôpital Tenon & UFR Pierre et Marie-Curie, Université Paris 6, 75970 Paris. jean.lacau@tnn.aphp.fr
D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000628:therapy*; D003937:Diagnosis, Differential; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008207:Lymphatic Metastasis; D037981:Neck Dissection; D009367:Neoplasm Staging; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis / Q000628:therapy; D011379:Prognosis