Primary Management of Operable Locally Advanced Oral Cavity Squamous Cell Carcinoma: Current Concepts and Strategies

Ameya A Asarkar; Brent A Chang; Remco de Bree; Luiz P Kowalski; Orlando Guntinas-Lichius; Patrick J Bradley; Pim de Graaf; Primož Strojan; Karthik N Rao; Antti A Mäkitie; Fernando López; Alessandra Rinaldo; Carsten Palme; Eric M Genden; Alvaro Sanabria; Juan P Rodrigo; Alfio Ferlito

doi:10.1007/s12325-024-02861-6

Primary Management of Operable Locally Advanced Oral Cavity Squamous Cell Carcinoma: Current Concepts and Strategies

Adv Ther. 2024 Apr 20. doi: 10.1007/s12325-024-02861-6. Online ahead of print.

Authors

Ameya A Asarkar¹, Brent A Chang², Remco de Bree³, Luiz P Kowalski^{4

5}, Orlando Guntinas-Lichius⁶, Patrick J Bradley⁷, Pim de Graaf^{8

9}, Primož Strojan¹⁰, Karthik N Rao¹¹, Antti A Mäkitie¹², Fernando López¹³, Alessandra Rinaldo¹⁴, Carsten Palme^{15

16}, Eric M Genden¹⁷, Alvaro Sanabria¹⁸, Juan P Rodrigo¹⁹, Alfio Ferlito²⁰

Affiliations

¹ Department of Otolaryngology/Head and Neck Surgery, Louisiana Health Sciences Center, Shreveport, LA, 71103, USA. Ameya.asarkar@lsuhs.edu.
² Department of Otolaryngology/Head and Neck Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA.
³ Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands.
⁴ Head and Neck Surgery Department, University of Sao Paulo Medical School, Sao Paulo, Brazil.
⁵ Department of Head and Neck Surgery and Otorhinolaryngology, A C Camargo Cancer Center, São Paulo, Brazil.
⁶ Department of Otorhinolaryngology, Institute of Phoniatry/Pedaudiology, Jena University Hospital, Jena, Germany.
⁷ Department of ORLHNS, Queens Medical Centre Campus, Nottingham University Hospitals, Derby Road, Nottingham, NG7 2UH, UK.
⁸ Amsterdam UMC Location Vrije Universiteit, Radiology and Nuclear Medicine, de Boelelaan 1117, Amsterdam, The Netherlands.
⁹ Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands.
¹⁰ Department of Radiation Oncology, Institute of Oncology, 1000, Ljubljana, Slovenia.
¹¹ Department of Head and Neck Oncology, Sri Shankara Cancer Hospital and Research Center, Bangalore, India.
¹² Department of Otorhinolaryngology, Head and Neck Surgery, Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
¹³ ENT and Head and Neck Department, Hospital Universitario Central de Asturias, Oviedo, Spain.
¹⁴ ENT Unit, Policlinico Città di Udine, 33100, Udine, Italy.
¹⁵ Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, NSW, Australia.
¹⁶ Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
¹⁷ Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, NY, 10029, USA.
¹⁸ Department of Surgery, School of Medicine, Centro de Excelencia en Cirugia de Cabeza y Cuello-CEXCA, Universidad de Antioquia, Medellin, Colombia.
¹⁹ Department of Otolaryngology, Hospital Universitario Central de Asturias, IUOPA, University of Oviedo, CIBERONC, 33011, Oviedo, Spain.
²⁰ Coordinator of the International Head and Neck Scientific Group, 35030, Padua, Italy.

PMID: 38642199
DOI: 10.1007/s12325-024-02861-6

Abstract

Introduction: Locally advanced oral cavity carcinoma (LAOCSCC) is primarily treated with surgery followed by radiotherapy with or without chemotherapy.

Methods: A review of literature using PubMED was performed for studies reporting the management of LAOCSCC. Based on the reviewed literature and opinions of experts in the field, recommendations were made.

Results: Studies have shown that outcomes following resection of T4a and infranotch (inferior to mandibular notch) T4b are comparable. We discuss the concept of compartmental resection of LAOCSCC and issues concerning the management of the neck. Further, patients who refuse or are unable to undergo surgery can be treated with chemoradiotherapy with uncertain outcomes. The role of neoadjuvant chemotherapy has shown promise for organ (mandibular) preservation in a select subset of patients.

Conclusion: The management strategy for LAOCSCC should be determined in a multidisciplinary setting with emphasis on tumor control, functional preservation, and quality of life of the patient.

Keywords: Margins; Neoadjuvant chemotherapy, surgery; Oral cavity squamous cell carcinoma; TNM.

Publication types

Review