2006 Volume 32 Issue 3 Pages 300-305
Although surgery has played an important role in the treatment of advanced head and neck cancer, there are many cases of surgery with inconclusive evidence. We reviewed the evidence of head and neck surgery obtained by multi-institutional studies in foreign countries, and considered the direction to be taken in Japan in the future. We classified the studies into four groups: the comparison of surgery and other treatment methods, the comparison of two surgical methods, the analysis of the added value of some surgery, and the comparison of postoperative treatment. We reviewed the comparison of surgery and chemoradiation, the comparison of comprehensive neck dissection and selective neck dissection, the planned neck dissection after chemoradiation, and the comparison of postoperative radiation and chemoradiation. In order to carry a multi-institutional study, it is necessary to share a common language among the head and neck surgeons, radiation oncologists and medical oncologists. Clarifying the definition of unresectability and referring to the NCCN (National Comprehensive Cancer Network) clinical practice guideline are important for that purpose.
