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Oral Cavity Cancer

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Cancer of the Oral Cavity, Pharynx and Larynx

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Abstract

In the course of managing a patient with carcinoma of the oral cavity, depending on the clinical situation, the clinician will have to make crucial decisions in the diagnostic evaluation and treatment of the cancer. Based on the case of a patient with a squamous cell carcinoma of the anterior-lateral floor of the mouth, staged T2N0, this chapter presents a concise, comprehensive discussion of the best evidence available to enable the reader to decide what is the best method to assess mandibular invasion, whether or not the patient should undergo panendoscopy, have and ultrasound (US) of the neck, and a CT or MRI scan of the neck, and whether or not a PET scan or a PET/CT should be obtained. Then, based on the case of a patient with a squamous cell carcinoma of the lateral border of the tongue, clinically staged T2N0, the authors discuss pertinent decisions regarding the treatment of the primary tumor, such as whether to recommend surgery or radiation, how wide a margin of normal tissue should be resected around the tumor, emphasizing the implications of having initially positive margins. Regarding management of the cervical lymph nodes, the reader will find a thorough discussion of the available evidence supporting observation of the neck, sentinel node biopsy and elective neck dissection, as well as the evidence-based indications for postoperative adjuvant therapy.

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References

  1. Brown JS, Griffith JF, Phelps PD, Browne RM. A comparison of different imaging modalities and direct inspection after periosteal stripping in predicting the invasion of the mandible by oral squamous cell carcinoma. Br J Oral Maxillofac Surg. 1994;32:347–59.

    Article  CAS  PubMed  Google Scholar 

  2. Schimming R, Juengling FD, Lauer G, Altehofer C, Schmelzeisen R. Computer-aided 3-D 99mTc-DPD-SPECT reconstruction to assess mandibular invasion by intraoral squamous cell carcinoma: diagnostic improvement or not? J Cranio-Maxillo-Fac Surg. 2000;28:325–30.

    Article  CAS  Google Scholar 

  3. Acton CH, Layt C, Gwynne R, Cooke R, Seaton D. Investigative modalities of mandibular invasion by squamous cell carcinoma. Laryngoscope. 2000;110:2050–5.

    Google Scholar 

  4. Rao LP, Das SR, Mathews A, Naik BR, Chacko E, Pandey M. Mandibular invasion in oral squamous cell carcinoma: investigation by clinical examination and orthopantomogram. Int J Oral Maxillofac Surg. 2004;33:454–7.

    Article  CAS  PubMed  Google Scholar 

  5. Bolzoni A, Cappiello J, Piazza C, et al. Diagnostic accuracy of magnetic resonance imaging in the assessment of mandibular involvement in oral-oropharyngeal squamous cell carcinoma: a prospective study. Arch Otolaryngol Head Neck Surg. 2004;130:837–43.

    Article  PubMed  Google Scholar 

  6. Goerres GW, Schmid DT, Schuknecht B, Eyrich GK. Bone invasion in patients with oral cavity cancer: comparison of conventional CT with PET/CT and SPECT/CT [Erratum appears in Radiology. 2006;239(1):303]. Radiology. 2005;237:281–7.

    Article  PubMed  Google Scholar 

  7. Imaizumi A, Yoshino N, Yamada I, et al. A potential pitfall of MR imaging for assessing mandibular invasion of squamous cell carcinoma in the oral cavity. Am J Neuroradiol. 2006;27:114–22.

    CAS  PubMed  Google Scholar 

  8. Rajesh A, Khan A, Kendall C, Hayter J, Cherryman G. Can magnetic resonance imaging replace single photon computed tomography and computed tomography in detecting bony invasion in patients with oral squamous cell carcinoma? Br J Oral Maxillofac Surg. 2008;46:11–4.

    Article  PubMed  Google Scholar 

  9. Van Cann EM, Koole R, Oyen WJ, et al. Assessment of mandibular invasion of squamous cell carcinoma by various modes of imaging: constructing a diagnostic algorithm. Int J Oral Maxillofac Surg. 2008;37:535–41.

    Article  PubMed  Google Scholar 

  10. Albuquerque MA, Kuruoshi ME, Oliveira IR, Cavalcanti MG. CT assessment of the correlation between clinical examination and bone involvement in oral malignant tumors. Braz Oral Res. 2009;23:196–202.

    Article  PubMed  Google Scholar 

  11. Dreiseidler T, Alarabi N, Ritter L, et al. A comparison of multislice computerized tomography, cone-beam computerized tomography, and single photon emission computerized tomography for the assessment of bone invasion by oral malignancies. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112:367–74.

    Article  PubMed  Google Scholar 

  12. Handschel J, Naujoks C, Depprich RA, et al. CT-scan is a valuable tool to detect mandibular involvement in oral cancer patients. Oral Oncol. 2012;48:361–6.

    Article  PubMed  Google Scholar 

  13. Pandey M, Rao LP, Das SR. Predictors of mandibular involvement in cancers of the oromandibular region. J Oral Maxillofac Surg. 2009;67:1069–73.

    Article  PubMed  Google Scholar 

  14. Sharma SJ, Linke JJ, Kroll T, Klussmann JP, Guntinas-Lichius O, Wittekindt C. Current practice of tumour endoscopy in German ENT-clinics. Laryngorhinootologie. 2013;92:166–9.

    Article  CAS  PubMed  Google Scholar 

  15. Guardiola E, Chaigneau L, Villanueva C, Pivot X. Is there still a role for triple endoscopy as part of staging for head and neck cancer? Curr Opin Otolaryngol Head Neck Surg. 2006;14:85–8.

    PubMed  Google Scholar 

  16. Tsao GJ, Damrose EJ. Complications of esophagoscopy in an academic training program. Otolaryngol Head Neck Surg. 2010;142:500–4.

    Article  PubMed  Google Scholar 

  17. Guardiola E, Pivot X, Dassonville O, et al. Is routine triple endoscopy for head and neck carcinoma patients necessary in light of a negative chest computed tomography scan? Cancer. 2004;101:2028–33.

    Article  PubMed  Google Scholar 

  18. Davidson J, Gilbert R, Irish J, et al. The role of panendoscopy in the management of mucosal head and neck malignancy—a prospective evaluation. Head Neck. 2000;22:449–54; discussion 454–5.

    Article  CAS  PubMed  Google Scholar 

  19. Grossman TW. The incidence and diagnosis of secondary esophageal carcinoma in the head and neck cancer patient. Laryngoscope. 1989;99:1052–6.

    Article  CAS  PubMed  Google Scholar 

  20. Hung SH, Tsai MC, Liu TC, Lin HC, Chung SD. Routine endoscopy for esophageal cancer is suggestive for patients with oral, oropharyngeal and hypopharyngeal cancer. PLoS One. 2013;8(8):e72097.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Haberal I, Celik H, Gocmen H, Akmansu H, Yoruk M, Ozeri C. Which is important in the evaluation of metastatic lymph nodes in head and neck cancer: palpation, ultrasonography, or computed tomography? Otolaryngol Head Neck Surg. 2004;130:197–201.

    Article  PubMed  Google Scholar 

  22. Adams S, Baum RP, Stuckensen T, Bitter K, Hoer G. Prospective comparison of 18F-FDG PET with conventional imaging modalities (CT, MRI, US) in lymph node staging of head and neck cancer. Eur J Nucl Med. 1998;25:1255–60.

    Article  CAS  PubMed  Google Scholar 

  23. Sakai O, Curtin HD, Romo LV, Som PM. Lymph node pathology. Benign proliferative, lymphoma, and metastatic disease [Review]. Radiol Clin North Am. 2000;38:979–98.

    Article  CAS  PubMed  Google Scholar 

  24. Umeda M, Komatsubara H, Ojima Y, et al. A comparison of brachytherapy and surgery for the treatment of stage I-II squamous cell carcinoma of the tongue. Int J Oral Maxillofac Surg. 2005;34:739–44.

    Article  CAS  PubMed  Google Scholar 

  25. van den Brekel MWM, van der Waal I, Meijer CJLM, Freeman JL, Castelijns JA, Snow GB. The incidence of micrometastases in neck dissection specimens obtained from elective neck dissections. Laryngoscope. 1996;106:987–91.

    Article  PubMed  Google Scholar 

  26. DiNardo LJ. Lymphatics of the submandibular space. Laryngoscope. 1998;108:206–14.

    Article  CAS  PubMed  Google Scholar 

  27. van den Brekel M, Castelijns J, Stel H, Golding R, Meyer C, Snow G. Modern imaging techniques and ultrasound guided aspiration cytology for the assessment of neck node metastases: a prospective comparative study. Eur Arch Otorhinolaryngol. 1993;250:11–7.

    Article  PubMed  Google Scholar 

  28. Nieuwenhuis EJC, Castelijns JA, Pijpers R, et al. Wait-and-see policy for the N0 neck in early-stage oral and oropharyngeal squamous cell carcinoma using ultrasonography-guided cytology: is there a role for identification of the sentinel node? Head Neck. 2002;24:282–9.

    Article  PubMed  Google Scholar 

  29. Wensing BM, Merkx MA, De Wilde PC, Marres HA, Van den Hoogen FJ. Assessment of preoperative ultrasonography of the neck dissection in patients with oral squamous cell carcinoma. Oral Oncol. 2010;46:87–91.

    Article  CAS  PubMed  Google Scholar 

  30. Gallo O, Boddi V, Parrella F, Storchi O. Treatment of the clinically negative neck in laryngeal cancer patients. Head Neck. 1996;18:566–72.

    Article  CAS  PubMed  Google Scholar 

  31. Stokkel MP, ten Broek FW, Hordijk GJ, Koole R, van Rijk PP. Preoperative evaluation of patients with primary head and neck cancer using dual-head 18-fluorodeoxyglucose positron emission tomography. Ann Surg. 2000;231:229–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Braams JW, Pruim J, Freling NJ, et al. Detection of lymph node metastases of squamous-cell cancer of the head and neck with FDG-PET and MRI. J Nucl Med. 1995;36:211–6.

    CAS  PubMed  Google Scholar 

  33. Kyzas PA, Evangelou E, Denaxa-Kyza D, Ioannidis JPA. 18F-fluorodeoxyglucose positron emission tomography to evaluate cervical node metastases in patients with head and neck squamous cell carcinoma: a meta-analysis. J Natl Cancer Inst. 2008;100:712–20.

    Article  PubMed  Google Scholar 

  34. Ng SH, Yen TC, Chang JT, et al. Prospective study of [18F]fluorodeoxyglucose positron emission tomography and computed tomography and magnetic resonance imaging in oral cavity squamous cell carcinoma with palpably negative neck. J Clin Oncol. 2006;24:4371–6.

    Article  PubMed  Google Scholar 

  35. Ozer ENB, Meacham R, Ryoo C, Agrawal A, Schuller DE. The value of PET/CT to assess clinically negative necks. Eur Arch Otorhinolaryngol. 2012;269:2411–4.

    Article  PubMed  Google Scholar 

  36. Liao LJLW, Hsu WL, Wang CT, Lai MS. Detection of cervical lymph node metastasis in head and neck cancer patients with clinically N0 neck--a meta-analysis comparing different imaging modalities. BMC Cancer. 2012;12:236.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Yamazaki H, Yoshida K, Yoshioka Y, et al. High dose rate brachytherapy for oral cancer. J Radiat Res. 2013;54:1–17.

    Article  PubMed  Google Scholar 

  38. Delclos L, Lindberg RD, Fletcher GH. Squamous cell carcinoma of the oral tongue and floor of mouth. Evaluation of interstitial radium therapy. Am J Roentgenol. 1976;126:223–8.

    Article  CAS  Google Scholar 

  39. Fujita M, Hirokawa Y, Kashiwado K, et al. Interstitial brachytherapy for stage I and II squamous cell carcinoma of the oral tongue: factors influencing local control and soft tissue complications. Int J Radiat Oncol Biol Phys. 1999;44:767–75.

    Article  CAS  PubMed  Google Scholar 

  40. Yuen PW, Lam KY, Chan AC, Wei WI, Lam LK. Clinicopathological analysis of local spread of carcinoma of the tongue. Am J Surg. 1998;175:242–4.

    Article  CAS  PubMed  Google Scholar 

  41. Chaturvedi P, Datta S, Nair S, et al. Gross examination by the surgeon as an alternative to frozen section for assessment of adequacy of surgical margin in head and neck squamous cell carcinoma. Head Neck. 2014;36:557–63.

    Article  PubMed  Google Scholar 

  42. Onofre MA, Sposto MR, Navarro CM. Reliability of toluidine blue application in the detection of oral epithelial dysplasia and in situ and invasive squamous cell carcinomas. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;91:535–40.

    Article  CAS  PubMed  Google Scholar 

  43. Epstein JB, Guneri P. The adjunctive role of toluidine blue in detection of oral premalignant and malignant lesions. Curr Opin Otolaryngol Head Neck Surg. 2009;17:79–87.

    Article  PubMed  Google Scholar 

  44. Junaid M, Choudhary MM, Sobani ZA, et al. A comparative analysis of toluidine blue with frozen section in oral squamous cell carcinoma. World J Surg Oncol. 2012;10:57.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Guillemaud JP, Patel RS, Goldstein DP, Higgins KM, Enepekides DJ. Prognostic impact of intraoperative microscopic cut-through on frozen section in oral cavity squamous cell carcinoma. J Otolaryngol Head Neck Surg. 2010;39:370.

    PubMed  Google Scholar 

  46. Patel RS, Goldstein DP, Guillemaud J, et al. Impact of positive frozen section microscopic tumor cut-through revised to negative on oral carcinoma control and survival rates. Head Neck. 2010;32:1444–51.

    Article  PubMed  Google Scholar 

  47. Vandenbrouck C, Sancho-Garnier H, Chassagne D, Saravane D, Cachin Y, Micheau C. Elective versus therapeutic radical neck dissection in epidermoid carcinoma of the oral cavity: results of a randomized clinical trial. Cancer. 1980;46:386–90.

    Article  CAS  PubMed  Google Scholar 

  48. Fakih A, Rao R, Borges A, Patel A. Elective versus therapeutic neck dissection in early carcinoma of the oral tongue. Am J Surg. 1989;158:309.

    Article  CAS  PubMed  Google Scholar 

  49. Kligerman JLR, Soares JR, et al. Supraomohyoid neck dissection in the treatment of T1/T2 squamous cell carcinoma of oral cavity. Am J Surg. 1994;168:391–3.

    Article  CAS  PubMed  Google Scholar 

  50. D’Cruz AK, Siddachari RC, Walvekar RR, et al. Elective neck dissection for the management of the N0 neck in early cancer of the oral tongue: need for a randomized controlled trial. Head Neck. 2009;31:618–24.

    Article  PubMed  Google Scholar 

  51. Yuen AP, Ho CM, Chow T, et al. Prospective randomized study of selective neck dissection versus observation for N0 neck of early tongue carcinoma. Head Neck. 2009;31:765–72.

    Article  PubMed  Google Scholar 

  52. Shoaib TM, Soutar DSM. Sentinel node biopsy in head and neck cancer. Curr Opin Otolaryngol Head Neck Surg. 2001;9:79–84.

    Article  Google Scholar 

  53. Ross GL, Soutar DS, MacDonald DG, Shoaib T, Camilleri IG, Robertson AG. Improved staging of cervical metastases in clinically node-negative patients with head and neck squamous cell carcinoma. Ann Surg Oncol. 2004;11:213–8.

    Article  CAS  PubMed  Google Scholar 

  54. Mozzillo N, Chiesa F, Botti G, et al. Sentinel node biopsy in head and neck cancer. Ann Surg Oncol. 2001;8(Suppl):105S.

    Google Scholar 

  55. Ross GL, Soutar DS, Gordon MD, et al. Sentinel node biopsy in head and neck cancer: preliminary results of a multicenter trial. Ann Surg Oncol. 2004;11:690–6.

    Article  PubMed  Google Scholar 

  56. Ross GL, Shoaib T, Soutar DS, et al. The first international conference on sentinel node biopsy in mucosal head and neck cancer and adoption of a multicenter trial protocol. Ann Surg Oncol. 2002;9:406–10.

    Article  CAS  PubMed  Google Scholar 

  57. Hamakawa H, Fukizumi M, Bao Y, et al. Genetic diagnosis of micrometastasis based on SCC antigen mRNA in cervical lymph nodes of head and neck cancer. Clin Exp Metastasis. 1999;17:593–9.

    Article  CAS  PubMed  Google Scholar 

  58. Shores CG, Yin X, Funkhouser W, Yarbrough W. Clinical evaluation of a new molecular method for detection of micrometastases in head and neck squamous cell carcinoma. Arch Otolaryngol Head Neck Surg. 2004;130:937–42.

    Article  PubMed  Google Scholar 

  59. Civantos F, Zitsch R, Bared A. Sentinel node biopsy in oral squamous cell carcinoma. J Surg Oncol. 2007;96:330–6.

    Article  PubMed  Google Scholar 

  60. Civantos FJ, Zitsch RP, Schuller DE, et al. Sentinel lymph node biopsy accurately stages the regional lymph nodes for T1-T2 oral squamous cell carcinomas: results of a prospective multi-institutional trial. J Clin Oncol. 2010;28:1395–400.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Coskun HHMJ, Robbins TK, Silver CE, Strojan PZ, Teymoortash A, Pellitteri PK, et al. Current philosophy in the surgical management of neck metastases for head and neck squamous cell carcinoma. Head Neck. 2015;37(6):915–26.

    Article  PubMed  Google Scholar 

  62. Brazilian Head and Neck Cancer Study Group. Results of a prospective trial on elective modified radical classical versus supraomohyoid neck dissection in the management of oral squamous carcinoma. Am J Surg. 1998;176:422–7.

    Google Scholar 

  63. Ambrosch P, Freudenberg L, Kron M, Steiner W. Selective neck dissection in the management of squamous cell carcinoma of the upper digestive tract. Eur Arch Otorhinolaryngol. 1996;253:329–35.

    Article  CAS  PubMed  Google Scholar 

  64. Zhang B, Xu ZG, Tang PZ. Lateral neck dissection vs radical neck dissection in the management of supraglottic carcinoma with pathologically negative nodes [Chinese]. Chung Hua Erh Pi Yen Hou Ko Tsa Chih [Chin J Otorhinolaryngol]. 2003;38:426–9.

    Google Scholar 

  65. Leon X, Quer M, Orus C, Sancho FJ, Bague S, Burgues J. Selective dissection of levels II-III with intraoperative control of the upper and middle jugular nodes: a therapeutic option for the N0 neck. Head Neck. 2001;23:441–6.

    Article  CAS  PubMed  Google Scholar 

  66. Pitman KT, Johnson JT, Myers EN. Effectiveness of selective neck dissection for management of the clinically negative neck. Arch Otolaryngol Head Neck Surg. 1997;123:917–22.

    Article  CAS  PubMed  Google Scholar 

  67. Spiro RH, Gallo O, Shah JP. Selective jugular node dissection in patients with squamous carcinoma of the larynx or pharynx. Am J Surg. 1993;166:399–402.

    Article  CAS  PubMed  Google Scholar 

  68. Byers RM, Clayman GL, McGill D, et al. Selective neck dissections for squamous carcinoma of the upper aerodigestive tract: patterns of regional failure. Head Neck. 1999;21:499–505.

    Article  CAS  PubMed  Google Scholar 

  69. Myers EN, Fagan JF. Management of the neck in cancer of the larynx [Review]. Ann Otol Rhinol Laryngol. 1999;108:828–32.

    Article  CAS  PubMed  Google Scholar 

  70. Davidson J, Khan Y, Gilbert R, Birt BD, Balogh J, MacKenzie R. Is selective neck dissection sufficient treatment for the N0/Np+ neck? J Otolaryngol. 1997;26:229–31.

    CAS  PubMed  Google Scholar 

  71. Clayman GL, Frank DK. Selective neck dissection of anatomically appropriate levels is as efficacious as modified radical neck dissection for elective treatment of the clinically negative neck in patients with squamous cell carcinoma of the upper respiratory and digestive tracts. Arch Otolaryngol Head Neck Surg. 1998;124:348–52.

    Article  CAS  PubMed  Google Scholar 

  72. Houck JR, Medina JE. Management of cervical lymph nodes in squamous carcinomas of the head and neck [Review]. Semin Surg Oncol. 1995;11:228–39.

    Article  CAS  PubMed  Google Scholar 

  73. Pellitteri PK, Robbins KT, Neuman T. Expanded application of selective neck dissection with regard to nodal status. Head Neck. 1997;19:260–5.

    Article  CAS  PubMed  Google Scholar 

  74. Byers RM, Weber RS, Andrews T, McGill D, Kare R, Wolf P. Frequency and therapeutic implications of “skip metastases” in the neck from squamous carcinoma of the oral tongue. Head Neck. 1997;19:14–9.

    Article  CAS  PubMed  Google Scholar 

  75. De Zinis LO, Bolzoni A, Piazza C, Nicolai P. Prevalence and localization of nodal metastases in squamous cell carcinoma of the oral cavity: role and extension of neck dissection. Eur Arch Otorhinolaryngol. 2006;263:1131–5.

    Article  PubMed  Google Scholar 

  76. Crean SJ, Hoffman A, Potts J, Fardy MJ. Reduction of occult metastatic disease by extension of the supraomohyoid neck dissection to include level IV. Head Neck. 2003;25:758–62.

    Article  PubMed  Google Scholar 

  77. Khafif A, Lopez-Garza JR, Medina JE. Is dissection of level IV necessary in patients with T1-T3 N0 tongue cancer? Laryngoscope. 2001;111:1088–90.

    Article  CAS  PubMed  Google Scholar 

  78. Shah JP, Candela FC, Poddar AK. The patterns of cervical lymph node metastases from squamous carcinoma of the oral cavity. Cancer. 1990;66:109–13.

    Article  CAS  PubMed  Google Scholar 

  79. Li XM, Wei WI, Guo XF, Yuen PW, Lam LK. Cervical lymph node metastatic patterns of squamous carcinomas in the upper aerodigestive tract. J Laryngol Otol. 1996;110:937–41.

    Article  CAS  PubMed  Google Scholar 

  80. Wang X, Tu G, Tang P. The treatment of tongue squamous cell with N0. Zhonghua kou qiang yi xue za zhi [Chin J Stomatol]. 2000;35:12–4.

    Google Scholar 

  81. Looser KG, Shah JP, Strong EW. The significance of “positive” margins in surgically resected epidermoid carcinomas. Head Neck Surg. 1978;1:107–11.

    Article  CAS  PubMed  Google Scholar 

  82. Mantravadi RV, Haas RE, Liebner EJ, Skolnik EM, Applebaum EL. Postoperative radiotherapy for persistent tumor at the surgical margin in head and neck cancers. Laryngoscope. 1983;93:1337–40.

    CAS  PubMed  Google Scholar 

  83. Mirimanoff RO, Wang CC, Doppke KP. Combined surgery and postoperative radiation therapy for advanced laryngeal and hypopharyngeal carcinomas. Int J Radiat Oncol Biol Phys. 1985;11:499–504.

    Article  CAS  PubMed  Google Scholar 

  84. Carter RL, Tanner NS, Clifford P, Shaw HJ. Perineural spread in squamous cell carcinomas of the head and neck: a clinicopathological study. Clin Otolaryngol Allied Sci. 1979;4:271–81.

    Article  CAS  PubMed  Google Scholar 

  85. Binmadi NO, Basile JR. Perineural invasion in oral squamous cell carcinoma: a discussion of significance and review of the literature. Oral Oncol. 2011;47:1005–10.

    Article  PubMed  Google Scholar 

  86. Shah JP, Cendon RA, Farr HW, Strong EW. Carcinoma of the oral cavity: factors affecting treatment failure at the primary site and neck. Am J Surg. 1976;132:504–7.

    Article  CAS  PubMed  Google Scholar 

  87. Olsen KD, Caruso M, Foote RL, et al. Primary head and neck cancer: histopathologic predictors of recurrence after neck dissection in patients with lymph node involvement. Arch Otolaryngol Head Neck Surg. 1994;120:1370–4.

    Article  CAS  PubMed  Google Scholar 

  88. Johnson JT, Barnes EL, Myers EN, Schramm VL, Jr., Borochovitz D, Sigler BA. The extracapsular spread of tumors in cervical node metastasis. Arch Otolaryngol (Chicago, IL: 1960). 1981;107:725–9.

    Google Scholar 

  89. Peters LJ, Goepfert H, Ang KK, et al. Evaluation of the dose for postoperative radiation therapy of head and neck cancer: first report of a prospective randomized trial. Int J Radiat Oncol Biol Phys. 1993;26:3–11.

    Article  CAS  PubMed  Google Scholar 

  90. Ang KK, Trotti A, Brown BW, et al. Randomized trial addressing risk features and time factors of surgery plus radiotherapy in advanced head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2001;51:571–8.

    Article  CAS  PubMed  Google Scholar 

  91. Huang J, Barbera L, Brouwers M, Browman G, Mackillop WJ. Does delay in starting treatment affect the outcomes of radiotherapy? A systematic review. J Clin Oncol. 2003;21:555–63.

    Article  PubMed  Google Scholar 

  92. Chen Z, King W, Pearcey R, Kerba M, Mackillop WJ. The relationship between waiting time for radiotherapy and clinical outcomes: a systematic review of the literature. Radiother Oncol. 2008;87:3–16.

    Google Scholar 

  93. Bernier J, Domenge C, Ozsahin M, et al. Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med. 2004;350:1945–52.

    Article  CAS  PubMed  Google Scholar 

  94. Cooper JS, Pajak TF, Forastiere AA, et al. Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med. 2004;350:1937–44.

    Article  PubMed  Google Scholar 

  95. Cooper JS, Pajak TF, Forastiere AA, et al. Long-term survival results of a phase III intergroup trial (RTOG 95-01) of surgery followed by radiotherapy vs. radiochemotherapy for resectable high risk squamous cell carcinoma of the head and neck. Int J Radiat Oncol. 2006;66:S14–5.

    Article  Google Scholar 

  96. Fietkau R, Lautenschlager C, Sauer R, et al. Postoperative concurrent radiochemotherapy versus radiotherapy in high-risk SCCA of the head and neck: results of the German phase III trial ARO 96-3. J Clin Oncol. 2006;24:281s.

    Google Scholar 

  97. Adelstein DJ, Li Y, Adams GL, et al. An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol. 2003;21:92–8.

    Article  PubMed  Google Scholar 

  98. 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.

    Article  PubMed  Google Scholar 

  99. Pignon JP, Bourhis J, Domenge C, Designe L. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-analysis of chemotherapy on head and neck cancer. Lancet. 2000;355:949–55.

    Article  CAS  PubMed  Google Scholar 

  100. Bourhis J, Amand C, Pignon JP. Update of MACH-NC (Meta-Analysis of Chemotherapy in Head & Neck Cancer) database focused on concomitant chemoradiotherapy. J Clin Oncol. 2004;22:5505.

    Google Scholar 

  101. Fan K-H, Lin C-Y, Kang C-J, et al. Postoperative concomitant chemoradiotherapy improved treatment outcomes of patients with oral cavity cancer with multiple-node metastases but no other major risk factors. PLoS One. 2014;9:e86922.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Otorhinolaryngology, College of Medicine, The University of Oklahoma, Oklahoma City, OK, USA

    Jesus E. Medina M.D. & Nilesh R. Vasan M.D.

  2. Department of Radiology, College of Medicine, The University of Oklahoma, Oklahoma City, OK, USA

    Anthony Alleman M.D.

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  1. Jesus E. Medina M.D.
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Correspondence to Jesus E. Medina M.D. .

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  1. Department of Otolaryngology, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma, USA

    Jesus E. Medina

  2. College of Medicine, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma, USA

    Nilesh R. Vasan

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Medina, J.E., Vasan, N.R., Alleman, A. (2016). Oral Cavity Cancer. In: Medina, J., Vasan, N. (eds) Cancer of the Oral Cavity, Pharynx and Larynx. Springer, Cham. https://doi.org/10.1007/978-3-319-18630-6_2

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