Management of the Neck in Squamous Cell Carcinoma of the Oral Cavity and Oropharynx

Publication Date: February 27, 2019

Key Points

Key Points

Although anatomically adjacent to one another, accumulating data suggests that, in many ways, squamous cell carcinoma of oral cavity (SCCOC) and oropharynx (SCCOP) may be distinct diseases from a biological perspective.

Oral SCC is predominately associated with tobacco and betel nut use. On the other hand, SCCOP is increasing in incidence in recent decades due to chronic latent infections of the human papillomavirus (HPV) and appears to disproportionately affect younger people.

The majority of patients with SCCOP have node-positive (cN+) necks at presentation, and 10-40% of patients without cN+ necks at presentation will have occult nodal metastases in both SCCOC and SCCOP. As such, management of the neck is a critical component of high quality oncologic care of these patients.

Treatment

...Treat...

...Oral Cavity...

...patients with oral cavity SCC clas...

...nts with oral cavity SCC classified as cT1, cN0...

...th a cN0 neck, an ipsilateral electiv...

...ients with a cN+ contralateral neck, a contralate...

...l therapeutic selective neck dissection for a clin...

...neck radiotherapy should NOT be administer...

...djuvant neck radiotherapy should be administer...

...vant neck radiotherapy should be administer...

...juvant chemoradiotherapy using intra...

...y cisplatin may be administered with p...

...tive neck dissection is the preferred approac...

...have undergone ipsilateral neck dis...


...Or...

...tients with lateralized oropharynge...

...h lateralized oropharyngeal cancer who have...

...nts with tumors extending to the midline tongue-...

...approach should be offered to patients wit...

Patients with biopsy-proven distant meta...

...can at ≥12 weeks after completion of radiatio...

...tients who complete radiation/chemoradi...

...scan at ≥12 weeks shows mild FDG u...


...ment Algorithm for Management of the Ne...


...2. Treatment Algorithm for Management of the...