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

  • Joseph Zenga
  • Jeremy D. RichmonEmail author
Chapter
Part of the Difficult Decisions in Surgery: An Evidence-Based Approach book series (DDSURGERY)

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.

Keywords

Oropharyngeal cancer Tongue Tonsil Transoral robotic Transoral laser microsurgery TORS TLMS HPV Radiation 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Otolaryngology and Communication Sciences, Division of Head and Neck Surgical Oncology and ReconstructionMedical College of WisconsinMilwaukeeUSA
  2. 2.Department of Otolaryngology, Massachusetts Eye and Ear InfirmaryHarvard Medical SchoolBostonUSA

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