The role of the head and neck surgeon in contemporary multidisciplinary treatment programs for advanced head and neck cancer.
OBJECTIVE
The advent of contemporary multidisciplinary treatment programs for head and neck cancer has led to a shift away from primary surgery for advanced pharyngeal and laryngeal carcinomas, in favor of concurrent chemoradiation therapy. Although primary surgical resection may no longer be the most commonly selected initial therapy for these patients, the head and neck surgeon should remain a key participant in their multidisciplinary care. We review the various ways in which the head and neck surgeon contributes to the care of these patients.


RESULTS
The surgeon fills many critical roles throughout chemoradiation therapy of advanced head and neck cancer, including initial diagnosis and staging, selection of initial therapy, pretreatment airway and nutritional support, patient assessment during and following therapy, evaluation of tumor response, salvage surgery, and management of late effects following chemoradiation therapy.


CONCLUSIONS
Continued involvement by a head and neck surgeon throughout all of the phases of chemoradiation therapy of patients with advanced head and neck cancer should be maintained by the multidisciplinary team.
Wong
Richard J
RJ
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, USA.
Shah
Jatin P
JP
D003131:Combined Modality Therapy; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D033183:Interdisciplinary Communication; D008279:Magnetic Resonance Imaging; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging / Q000379:methods*; D049268:Positron-Emission Tomography; D011379:Prognosis; D016730:Program Development; D014057:Tomography, X-Ray Computed