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Is open surgery for head and neck cancers truly declining?

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Abstract

In the past two decades, major modifications in the way we treat head and neck cancers, due to advances in technology and medical oncology, have led to a decline in the use of open surgery as first-line treatment of cancers arising from several primary tumor sites. The incidence of tobacco- and alcohol-related squamous cell carcinoma of the pharynx and larynx has been steadily decreasing, with a rise in the incidence of human papillomavirus-related oropharyngeal tumors and the use of minimally invasive endoscopic surgery and non-surgical treatment modalities has increased in the treatment of all of these tumors. However, open surgery remains the initial definitive treatment modality for other tumors, including tumors of the skin, oral cavity, sinonasal cavities and skull base, salivary glands, thyroid and sarcomas. Selected group of nasal, paranasal, base of the skull and thyroid tumors are also candidates for minimally invasive procedures. For some indications, the rate of open surgery has actually increased in the past decade, with an increase in the incidence of oral cavity, thyroid and skin cancer, an increase in the number of neck dissections performed, and an increase in salvage surgery and free flap reconstruction. The use of minimally invasive, technology-based surgery—with the use of lasers, operating microscopes, endoscopes, robots and image guidance—has increased. Technology, epidemiology and advances in other domains such as tissue engineering and allotransplantations may further change the domains of competencies for future head and neck surgeons.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif Cedex, France

    Dana M. Hartl

  2. Laboratoire de Phonétique et de Phonologie, Sorbonne Nouvelle, Paris, France

    Dana M. Hartl

  3. Department of Otolaryngology-Head and Neck Surgery, and Voice, Biomaterials and Head and Neck Oncology Research Laboratory, University Paris V, European Hospital Georges Pompidou, Paris Cedex, France

    Daniel F. Brasnu

  4. Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Jatin P. Shah

  5. Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, AZ, USA

    Michael L. Hinni

  6. Department of Otolaryngology-Head and Neck Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands

    Robert P. Takes

  7. Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, USA

    Kerry D. Olsen

  8. Department Otorhinolaryngology-Head and Neck Surgery, Centro de Tratamento e Pesquisa Hospital do Cancer A.C. Camargo, São Paulo, Brazil

    Luiz P. Kowalski

  9. Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain

    Juan P. Rodrigo & Carlos Suárez

  10. Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain

    Juan P. Rodrigo & Carlos Suárez

  11. Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia

    Primož Strojan

  12. Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA

    Gregory T. Wolf

  13. ENT Clinic, University of Udine, Udine, Italy

    Alessandra Rinaldo & Alfio Ferlito

  14. Department of Radiation Oncology, University of Florida, Gainesville, FL, USA

    William M. Mendenhall

  15. Department of Otolaryngology-Head and Neck Surgery, Newcastle upon Tyne Foundation Hospitals, NHS Trust, Newcastle upon Tyne, UK

    Vinidh Paleri

  16. Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Arlene A. Forastiere

  17. Department of Otolaryngology-Head and Neck Surgery, Philipp University, Marburg, Germany

    Jochen A. Werner

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  1. Dana M. Hartl
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Correspondence to Alfio Ferlito.

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This paper was written by members and invitees of the International Head and Neck Scientific Group (http://www.IHNSG.com).

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Hartl, D.M., Brasnu, D.F., Shah, J.P. et al. Is open surgery for head and neck cancers truly declining?. Eur Arch Otorhinolaryngol 270, 2793–2802 (2013). https://doi.org/10.1007/s00405-012-2322-y

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  • DOI: https://doi.org/10.1007/s00405-012-2322-y

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