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Updates and Controversies in the Management of Head and Neck Malignancy

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Head and Neck Surgery : Surgical Landmark and Dissection Guide

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Abstract

The booming knowledge about the cancer etiology and pathogenesis has markedly changed the management of head and neck squamous cell carcinoma (HNSCC) in the last few decades. Innovation in different therapeutic modalities like surgery, radiotherapy, and chemotherapy has an admiring impact on cancer control in primary site and neck, overall survival, and issues related to quality of life. Relatively better outcome has shifted the therapeutic aim from drastic ablation to organ conservation and functional revival. Accumulation of different imaging systems, e.g., CT/MRI, PET/CT fusion scan, and very recently narrowband imaging, has had a breakthrough impact on the assessment and decision-making about treatment. Use of laser and robot has been providing opportunities to deal with some difficult areas surgically like nasopharynx, oropharynx, and hypopharynx. IMRT is a breakthrough in the field of radiotherapy.

Some controversies are still existing regarding investigative and treatment protocol like PET/CT and sentinel lymph node biopsy (SLNB). Whether the HPV-positive oropharyngeal carcinomas are being subjected to overtreatment is a concern. Targeted therapy aimed at epidermal growth factor receptor, vascular endothelial growth factor, etc. and immunotherapy with PD-1 and PD-L1 immune checkpoint inhibitor are also promising in the field of HNSCC management.

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Authors and Affiliations

  1. Head & Neck Surgery Division, Department of ORLHNS, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

    Belayat Hossain Siddiquee

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  1. Belayat Hossain Siddiquee
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  1. Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia

    Norhafiza Mat Lazim

  2. Department of Anatomy, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia

    Zul Izhar Mohd Ismail

  3. Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia

    Baharudin Abdullah

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Siddiquee, B.H. (2022). Updates and Controversies in the Management of Head and Neck Malignancy. In: Mat Lazim, N., Mohd Ismail, Z.I., Abdullah, B. (eds) Head and Neck Surgery : Surgical Landmark and Dissection Guide. Springer, Singapore. https://doi.org/10.1007/978-981-19-3854-2_19

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