The role of the head and neck surgeon in contemporary multidisciplinary treatment programs for advanced head and neck cancer.

PURPOSE OF REVIEW: The advent of contemporary multidisciplinary treatment programs for head and neck cancer has led to a shift away from primary surgery for advanced pharyngeal and laryngeal carcinomas, in favor of concurrent chemoradiation therapy. Although primary surgical resection may no longer be the most commonly selected initial therapy for these patients, the head and neck surgeon should remain a key participant in their multidisciplinary care. We review the various ways in which the head and neck surgeon contributes to the care of these patients.

RECENT FINDINGS: The surgeon fills many critical roles throughout chemoradiation therapy of advanced head and neck cancer, including initial diagnosis and staging, selection of initial therapy, pretreatment airway and nutritional support, patient assessment during and following therapy, evaluation of tumor response, salvage surgery, and management of late effects following chemoradiation therapy.

SUMMARY: Continued involvement by a head and neck surgeon throughout all of the phases of chemoradiation therapy of patients with advanced head and neck cancer should be maintained by the multidisciplinary team.