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

...eatment...

Oral Cavity

...h oral cavity SCC classified as cT2-cT4,...

...or patients with oral cavity SCC c...

...ents with a cN0 neck, an ipsilateral elective ne...

In patients with a cN+ contralateral...

...therapeutic selective neck dissecti...

...eck radiotherapy should NOT be administered to pa...

...diotherapy should be administered to patients wi...

...juvant neck radiotherapy should be administered t...

...hemoradiotherapy using intravenous bolu...

...ly cisplatin may be administered with...

...ck dissection is the preferred approach for...

For patients who have undergone ipsil...


...pharynx...

...lateralized oropharyngeal carcinoma who are...

...ients with lateralized oropharynge...

...ith tumors extending to the midline tongue-base o...

...gical approach should be offered to patien...

...ith biopsy-proven distant metastase...

...n at ≥12 weeks after completion of r...

...who complete radiation/chemoradiation...

...an at ≥12 weeks shows mild FDG uptak...


...Treatment Algorithm for Management of the Neck...


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