Head & neck
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There are no level I studies to guide treatment for resectable oropharyngeal squamous cell carcinoma (SCC). Treatment toxicities influence management recommendations. Ongoing investigations are examining deintensified treatments for human papillomavirus (HPV)-associated oropharyngeal SCC. ⋯ T1 to T2N0M0 resectable oropharyngeal SCC can be treated with surgery or radiation without chemotherapy. Patients with T1-2N1-2aM0 disease can receive radiation, chemoradiation, or transoral surgery with neck dissection and appropriate adjuvant therapy. Patients with T1-2N2b-3M0 disease should receive chemoradiation or transoral surgery with neck dissection and appropriate adjuvant therapy. Concurrent chemoradiation is preferred for T3 to T4 disease. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1299-1309, 2016.
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The nasoseptal flap has revolutionized reconstruction of ventral skull base defects. The past decade is also noticeable by the evolution of transoral robotic surgery (TORS). Reconstruction of the oropharyngeal defect is challenging. Good reconstructive options with less cicatricial retraction are desirable and still lacking in the literature. ⋯ The nasoseptal flap has shown to be feasible and reliable for reconstruction of the oropharyngeal defect after TORS. When soft palate resection is warranted, this flap provides excellent coverage. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2495-E2498, 2016.
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Comparative Study
Primary surgery for advanced-stage laryngeal cancer: A stage and subsite-specific survival analysis.
Treatment recommendations for advanced-stage laryngeal squamous cell carcinoma (SCC) have evolved significantly over the last 2 decades. ⋯ Patients with advanced-stage laryngeal SCC with T3 and T4a tumors, N0 neck disease, or supraglottic primaries have the greatest chance of survival when treated with primary surgery. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1380-1386, 2016.
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Recommended margins for thick cutaneous melanoma (Breslow thickness >4 mm; T4) have decreased over recent decades. Optimal margins and the role of sentinel node biopsy (SNB) in thick head and neck melanoma remain controversial. ⋯ Wider margins do not significantly improve locoregional recurrence or MSS. Sentinel lymph node involvement reflects a poor prognosis. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1373-1379, 2016.