Principles in the Management of Head and Neck Cancer

  • Shreya Bhattacharya


Head and neck cancers (H&N) are a significant problem in our country constituting approximately one-third cancer cases in contrast to 4–5% in the developed world [1]. Men are more commonly affected than women and the incidence increases with age. Ninety-eight percent of the patients are over 40 years old. Squamous cell cancer constitutes the most common pathology and includes cancers of the oral cavity, oropharynx, larynx and hypopharynx, nasopharynx, nasal cavity, and paranasal sinuses. Non-squamous types include thyroid cancer, salivary gland cancer, and sarcomas. The two most common etiological factors of head and neck cancer are tobacco and alcohol. Because of the exposure to these carcinogens to the entire epithelium of the aerodigestive tract, patients with H&N cancers have more chance for developing second primaries. Other factors implicated include viruses, occupational agents, pollutants, diet, and genetic influences. Infection with carcinogenic types of human papillomavirus (HPV, especially type 16) is a risk factor, particularly for oropharynx cancers [2].


  1. 1.
    Shah SB, Sharma S, D'Cruz AK. Head and neck oncology: the Indian scenario. South Asian J Cancer. 2016;5:104–5.CrossRefGoogle Scholar
  2. 2.
    Bhatia A, Burtness B. Human papillomavirus-associated oropharyngeal cancer: defining risk groups and clinical trials. J Clin Oncol. 2015;33:3243–50.CrossRefGoogle Scholar
  3. 3.
    NCCN. Head and Neck Cancer V.2.2017: NCCN Clinical Practice Guidelines.Google Scholar
  4. 4.
    Holsinger FC, Ferris RL. Transoral endoscopic head and neck surgery and its role within the multidisciplinary treatment paradigm of oropharynx cancer: robotics, lasers, and clinical trials. J Clin Oncol. 2015;33:3285–92.CrossRefGoogle Scholar
  5. 5.
    Schilling C, Stoeckli SJ, Haerle SK, et al. Sentinel European Node Trial (SENT): 3-year results of sentinel node biopsy in oral cancer. Eur J Cancer. 2015;51:2777–84.CrossRefGoogle Scholar
  6. 6.
    Bernier J, Cooper JS, Pajak TF, et al. Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (# 9501). Head Neck. 2005;27:843–50.CrossRefGoogle Scholar
  7. 7.
    Peretti G, Piazza C, Del Bon F, et al. Function preservation using transoral laser surgery for T2–T3 glottic cancer: oncologic, vocal, and swallowing outcomes. Eur Arch Otorhinolaryngol. 2013;270:2275–781.CrossRefGoogle Scholar
  8. 8.
    Forastiere AA, Zhang Q, Weber RS, et al. Long-term results of RTOG 91-11: a comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer. J Clin Oncol. 2013;31:845–52.CrossRefGoogle Scholar
  9. 9.
    Al-Sarraf M, LeBlanc M, Giri PG, et al. Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol. 1998;16:1310–7.CrossRefGoogle Scholar
  10. 10.
    Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26:1–133.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Shreya Bhattacharya
    • 1
  1. 1.Department of Surgical OncologyMax Super Speciality HospitalSaketIndia

Personalised recommendations