Recent advances in surgery for head and neck cancer.
OBJECTIVE
This paper reviews the advances in surgery in head and neck cancer patients.


RESULTS
Sentinel node biopsy is a promising diagnostic technique to detect occult lymph node metastases, especially in oral carcinomas. Fludeoxyglucose-PET seems to be useful in detecting recurrent (laryngeal) carcinoma after radiotherapy. The role of fludeoxyglucose-PET to detect residual disease in the neck after radiotherapy with or without chemotherapy is not yet clear. The armamentarium of reconstructive surgery is still expanding. Endonasal endoscopic, robotic surgery and image-guided surgery are used as minimal invasive surgery in selected patients. Other advances include photodynamic therapy, ultrasonic surgery and mechanical sutures.


CONCLUSIONS
New diagnostic techniques are used to avoid futile extensive surgery. Technical improvements have been made to treat head and neck cancer patients with minimal invasive surgery. Large prospective trials are needed to determine the indications for each technique.
de Bree
Remco
R
Department of Otolaryngology, VU University Medical Center, Amsterdam, The Netherlands.
Leemans
Charles René
CR
D002986:Clinical Trials as Topic; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D021701:Sentinel Lymph Node Biopsy / Q000639:trends; D013514:Surgical Procedures, Operative / Q000639:trends