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Surgical Versus Non-surgical Management of Early T-Stage Oropharyngeal Cancer

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Difficult Decisions in Head and Neck Oncologic Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

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Abstract

The management of early T-stage oropharyngeal cancer remains a controversial topic with an absence of high-level evidence supporting one treatment approach over another. The current status of best evidence demonstrates oncologic equivalency of these treatment modalities. The choice between surgical and non-surgical management of early stage OPSCC is therefore quite nuanced and is driven by patient selection, functional outcomes, cost-effectiveness, and patient preference. Transoral surgery alone in the appropriately selected patient has improved overall functional results as compared with definitive radiotherapy, however when adjuvant (chemo)radiotherapy is needed functional outcomes are worse and do not appear better than definitive radiotherapy alone. There are currently many ongoing de-intensification trials which will further inform which patients will benefit the most from a functional standpoint while preserving excellent oncologic outcomes.

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Authors and Affiliations

  1. Department of Otolaryngology and Communication Sciences, Division of Head and Neck Surgical Oncology and Reconstruction, Medical College of Wisconsin, Milwaukee, WI, USA

    Joseph Zenga

  2. Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA

    Jeremy D. Richmon

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  1. Joseph Zenga
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  2. Jeremy D. Richmon
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Correspondence to Jeremy D. Richmon .

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Editors and Affiliations

  1. Department of Surgery, Section of Otolaryngology-Head and Neck Surgery, University of Chicago, Chicago, IL, USA

    Zhen Gooi

  2. Department of Surgery, Section of Otolaryngology-Head and Neck Surgery, University of Chicago, Chicago, IL, USA

    Nishant Agrawal

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Zenga, J., Richmon, J.D. (2019). Surgical Versus Non-surgical Management of Early T-Stage Oropharyngeal Cancer. In: Gooi, Z., Agrawal, N. (eds) Difficult Decisions in Head and Neck Oncologic Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-030-15123-2_8

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  • DOI: https://doi.org/10.1007/978-3-030-15123-2_8

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