American Cancer Society
Atlas of Clinical Oncology Published Blumgart, Fong, Jarnagin
Hepatobiliary Cancer (2001)
Cameron
Pancreatic Cancer (2001)
Char
Tumors of the Eye and Ocular Adnexa (2001)
Eifel, Levenback
Cancer of the Female Lower Genital Tract (2001)
Shah
Head and Neck Cancer (2001)
Silverman
Oral Cancer (1998)
Sober, Haluska
Skin Cancer (2001)
Wiernik
Adult Leukemias (2001)
Willett
Cancer of the Lower Gastrointestinal Tract (2001)
Winchester, Winchester
Breast Cancer (2000)
Forthcoming Carroll, Grossfeld, Reese
Prostate Cancer (2001)
Clark, Duh, Jahan, Perrier
Endocrine Tumors (2002)
Droller
Urothelial Cancer (2002)
Fuller
Uterine and Endometrial Cancer (2003)
Ginsberg
Lung Cancer (2001)
Grossbard
Malignant Lymphomas (2001)
Ozols
Ovarian Cancer (2002)
Pollock
Soft Tissue Sarcomas (2001)
Posner, Vokes, Weichselbaum
Cancer of the Upper Gastrointestinal Tract (2001)
Prados
Brain Cancer (2001)
Raghavan
Germ Cell Tumors (2002)
Steele, Richie
Kidney Tumors (2003)
Volberding
Viral and Immunological Malignancies (2003)
Yasko
Bone Tumors (2002)
American Cancer Society
Atlas of Clinical Oncology Editors GLENN D. STEELE JR, MD Geisinger Health System THEODORE L. PHILLIPS, MD University of California BRUCE A. CHABNER, MD Harvard Medical School
Managing Editor TED S. GANSLER, MD, MBA Director of Health Content, American Cancer Society
American Cancer Society
Atlas of Clinical Oncology
Cancer of the Head and Neck Editor
Jatin P. Shah, MD, MS (Surg.), FACS, Hon. FRCS (Edin), Hon. FDSRCS (Lond) Chief, Head and Neck Service E.W. Strong Chair in Head and Neck Oncology Memorial Sloan-Kettering Cancer Center Professor of Surgery, Weill Medical College, Cornell University New York, New York Assistant Editor
Snehal G. Patel, MD, MS (Surg.), FRCS Clinical Research Associate Head and Neck Service Memorial Sloan-Kettering Cancer Center New York, New York Illustrator Alice Y. Chen
2001 BC Decker Inc Hamilton • London
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Contributors PETER E. ANDERSEN, MD, FACS Associate Professor Department of Otolaryngology, Head and Neck Surgery Oregon Health Sciences University Portland, Oregon Management of Cervical Metastasis JAY O. BOYLE, MD Assistant Attending Surgeon Head and Neck Service Memorial Sloan-Kettering Cancer Center; Assistant Professor Department of Otorhinolaryngology —Head and Neck Surgery Weill Medical College of Cornell University New York, New York Oral Cavity Cancer JOHN F. CAREW, MD Assistant Attending Surgeon Department of Otorhinolaryngology —Head and Neck Surgery New York Presbyterian Hospital; Assistant Professor Department of Otorhinolaryngology —Head and Neck Surgery The Weill Medical College of Cornell University New York, New York The Larynx: Advanced Stage Disease LANCEFORD M. CHONG, M.D. Associate Attending Radiation Oncologist Department of Radiation Oncology Memorial Sloan-Kettering Cancer Center New York, New York Head and Neck Radiation Oncology
PETER G. CORDEIRO, MD, FACS Associate Attending Surgeon Plastic and Reconstructive Surgery Service Memorial Sloan-Kettering Cancer Center; Associate Professor of Surgery Department of Surgery Weill Medical College of Cornell University New York, New York General Principles of Reconstructive Surgery for Head and Neck Cancer Mandible Reconstruction BRUCE J. DAVIDSON, MD, FACS Assistant Professor Deartment of Otolaryngology —Head and Neck Surgery Georgetown University Medical Center Washington, District of Columbia Epidemiology and Etiology JOSEPH J. DISA, MD Assistant Attending Surgeon Plastic and Reconstructive Surgery Service Memorial Sloan-Kettering Cancer Center; Assistant Professor Department of Surgery Weill Medical College of Cornell University New York, New York General Principles of Reconstructive Surgery for Head and Neck Cancer Mandible Reconstruction ANDREW G. HUVOS, MD Attending Pathologist Memorial Sloan-Kettering Cancer Center; Professor of Pathology Weill Medical College of Cornell University New York, New York Pathology of Head and Neck Tumors v
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CONTRIBUTORS
PAUL A. KEDESHIAN, MD Visiting Assistant Professor Division of Head and Neck Surgery University of California Medical Center Los Angeles, California Skull Base: Anterior and Middle Cranial Fossa Neurogenic and Vascular Tumors of the Head and Neck DANIEL J. KELLEY, MD Director, Head and Neck Oncology and Skull Base Surgery Department of Otolaryngology— Bronchoesophagology Assistant Professor Temple University School of Medicine Philadelphia, Pennsylvania Cancer of the Hypopharynx and Cervical Esophagus DENNIS H. KRAUS, MD, FACS Associate Attending Surgeon Head and Neck Service Memorial Sloan-Kettering Cancer Center; Associate Professor Department of Otorhinolaryngology —Head and Neck Surgery Weill Medical College of Cornell University New York, New York Cancer of the Nasal Cavity and Paranasal Sinuses Skull Base: Anterior and Middle Cranial Fossa DANIEL D. LYDIATT, DDS, MD, FACS Associate Professor Department of Otolaryngology/Head and Neck Surgery University of Nebraska Medical Center Omaha, Nebraska The Larynx: Early Stage Disease WILLIAM M. LYDIATT, MD, FACS Associate Professor Department of Otolaryngology/Head and Neck Surgery University of Nebraska Medical Center Omaha, Nebraska The Larynx: Early Stage Disease
FERNANDO C. MALUF, MD Associate Professor Division of Solid Tumor, Department of Medicine Sirio Libanes Hospital Sao Paolo, Brazil Chemotherapy and Chemoprevention in Head and Neck Cancer BERNARD B. O’MALLEY, MD Attending Radiologist The Princeton Medical Center Princeton, New Jersey Head and Neck Imaging SNEHAL G. PATEL, MD, MS, FRCS Clinical Research Associate Head and Neck Service Memorial Sloan-Kettering Cancer Center New York, New York Tumors of the Oropharynx Soft Tissue and Bone Tumors Thyroid and Parathyroid Tumors DAVID G. PFISTER, MD Associate Attending Physician Division of Solid Tumor Memorial Sloan-Kettering Cancer Center; Associate Professor, Department of Medicine Weill Medical College of Cornell University New York, New York Chemotherapy and Chemoprevention in Head and Neck Cancer MANJU L. PRASAD, MD Assistant Professor Department of Pathology Ohio State University Hospital Columbus, Ohio Pathology of Head and Neck Tumors SCOTT SAFFOLD, MD Resident, Department of Otolaryngology —Head and Neck Surgery Oregon Health Sciences University Portland, Oregon Management of Cervical Metastasis
CONTRIBUTORS
ERIC SANTAMARIA, MD Associate Professor Department of Surgery Hospital General Dr. Manuel Gea Gonzalez Mexico City, Mexico General Principles of Reconstructive Surgery for Head and Neck Cancer Mandible Reconstruction JATIN P. SHAH, MD, FACS Chief and Attending Surgeon Elliot W. Strong Chair in Head and Neck Oncology Head and Neck Service Memorial Sloan-Kettering Cancer Center; Professor, Department of Surgery Weill Medical College of Cornell University New York, New York Skin Cancers of the Head and Neck Tumors of the Oropharynx Skull Base: Anterior and Middle Cranial Fossa Neurogenic and Vascular Tumors of the Head and Neck Soft Tissue and Bone Tumors ASHOK R. SHAHA, MD, FACS Attending Surgeon Head and Neck Service Memorial Sloan-Kettering Cancer Center; Professor, Department of Surgery Weill Medical College of Cornell University New York, New York Thyroid and Parathyroid Tumors ERIC J. SHERMAN, MD Assistant Member Division of Population Science Department of Medical Oncology Fox Chase Cancer Center Philadelphia, Pennsylvania Chemotherapy and Chemoprevention in Head and Neck Cancer BHUVANESH SINGH, MD Assistant Attending Surgeon Head and Neck Service Memorial Sloan-Kettering Cancer Center; Assistant Professor
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Department of Otorhinolaryngology —Head and Neck Surgery Weill Medical College of Cornell University New York, New York Skin Cancers of the Head and Neck Rehabilitation and Quality of Life Assessment in Head and Neck Cancer JEFFREY D. SPIRO, MD, FACS Professor of Surgery University of Connecticut Health Science Center Farmington, Connecticut Salivary Tumors RONALD H. SPIRO, MD, FACS Professor of Surgery Head and Neck Service Memorial Sloan-Kettering Cancer Center New York, New York Salivary Tumors ELLIOT W. STRONG, MD, FACS Professor Emeritus Head and Neck Service Memorial Sloan-Kettering Cancer Center New York, New York Oral Cavity Cancer SUZANNE L. WOLDEN, MD Assistant Attending Radiation Oncologist Memorial Sloan-Kettering Cancer Center; Assistant Professor of Radiation Oncology Weill Medical College of Cornell University New York, New York Cancer of the Nasopharynx RICHARD J. WONG, MD Fellow, Head and Neck Service Memorial Sloan-Kettering Cancer Center New York, New York Cancer of the Nasal Cavity and Paranasal Sinuses IAN M. ZLOTOLOW, DMD Chief and Attending Dental Surgeon Dental Service Memorial Sloan-Kettering Cancer Center New York, New York Dental Oncology and Maxillofacial Prosthetics
Contents 1
Epidemiology and Etiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Bruce J. Davidson, MD, FACS 2
Pathology of Head and Neck Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Manju L. Prasad, MD, Andrew G. Huvos, MD 3
Head and Neck Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Bernard B. O’Malley, MD 4
Skin Cancers of the Head and Neck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Bhuvanesh Singh, MD, Jatin P. Shah, MD, FACS 5
Oral Cavity Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
Jay O. Boyle, MD, Elliot W. Strong, MD, FACS 6
Tumors of the Oropharynx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
Snehal G. Patel, MD, MS, FRCS, Jatin P. Shah, MD, FACS 7
Cancer of the Nasopharynx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Suzanne L. Wolden, MD 8
The Larynx: Advanced Stage Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
John F. Carew, MD 9
The Larynx: Early Stage Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
William M. Lydiatt, MD, FACS, Daniel D. Lydiatt, DDS, MD, FACS 10
Cancer of the Hypopharynx and Cervical Esophagus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Daniel J. Kelley, MD 11
Cancer of the Nasal Cavity and Paranasal Sinuses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
Richard J. Wong, MD, Dennis H. Kraus, MD, FACS
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CONTENTS
12
ix
Skull Base: Anterior and Middle Cranial Fossa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
Paul A. Kedeshian, MD, Dennis H. Kraus, MD, FACS, Jatin P. Shah, MD, FACS 13
Salivary Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240
Jeffrey D. Spiro, MD, FACS, Ronald H. Spiro, MD, FACS 14
Thyroid and Parathyroid Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
Ashok R. Shaha, MD, FACS, Snehal G. Patel, MD, MS, FRCS 15
Management of Cervical Metastasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 274
Peter E. Andersen, MD, FACS, Scott Saffold, MD 16
Neurogenic and Vascular Tumors of the Head and Neck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288
Paul A. Kedeshian, MD, Jatin P. Shah, MD, FACS 17
Soft Tissue and Bone Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309
Snehal G. Patel, MD, MS, FRCS, Jatin P. Shah, MD, FACS 18
General Principles of Reconstructive Surgery for Head and Neck Cancer . . . . . . . . . . . . . . . . . . . 330
Joseph J. Disa, MD, Eric Santamaria, MD, Peter G. Cordeiro, MD, FACS 19
Mandible Reconstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 358
Peter G. Cordeiro, MD, FACS, Eric Santamaria, MD, Joseph J. Disa, MD 20
Dental Oncology and Maxillofacial Prosthetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 376
Ian M. Zlotolow, DMD 21
Head and Neck Radiation Oncology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 395
Lanceford M. Chong, MD 22
Chemotherapy and Chemoprevention in Head and Neck Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . 444
Fernando C. Maluf, MD, Eric Sherman, MD, David G. Pfister, MD 23
Rehabilitation and Quality of Life Assessment in Head and Neck Cancer . . . . . . . . . . . . . . . . . . . 467
Bhuvanesh Singh, MD Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 478
Preface Although oral cancer is the sixth most common cancer worldwide, cancer of the head and neck is a rare disease in the western world. A higher incidence is reported in Southeast Asia as well as certain parts of Europe and Latin America. Tobacco and alcohol remain the most important etiologic factors; however, the primary site incidence of head and neck cancer varies throughout the world depending on the type of substance abuse and the extent of consumption. Management of these patients requires a team effort with expertise in various disciplines. As our understanding of the biology and natural history of cancers of the head and neck increases, efforts at preservation or restoration of form and function become increasingly important. These efforts are not only important in the surgical treatment of these tumors but are also important in the multidisciplinary, integrated treatment programs delivered by comprehensive treatment teams. Most major cancer centers, not only in the United States but also worldwide, now deliver optimal care for patients with cancers of the head and neck through the integrated efforts of multidisciplinary “disease-management” teams. Such disease-management teams work to develop treatment algorithms and establish guidelines for a unified treatment approach in order to maintain internal consistency, initiate investigative protocols, and push the frontiers in the battle against cancer. Such guidelines are also developed by the American Head and Neck Society (AHNS) and the National Cancer Center Network (NCCN). The focus has clearly been on outcome analysis and (whenever feasible), implementation of evidence-based medicine. These have provided excellent practice guidelines for the practitioner in the community and are rapidly becoming standards of care. The contributing authors in this book are or have been members of the head and neck disease-management team at Memorial Sloan-Kettering Cancer Center in New York. As a result, the treatment programs practiced at Memorial Sloan-Kettering Cancer Center tend to be reflected in the philosophies expressed in this book, though every attempt has been made to be comprehensive and to give a balanced view of other treatment approaches and report results. Thus, in spite of being a multi-authored book, the strength of this work is its internal consistency of diagnostic approaches, therapeutic decisions, multidisciplinary treatment programs, and surgical techniques. It is obviously impossible for a work of this nature to be either complete or permanently up-to-date; new technology will offer newer diagnostic approaches that will impact on the development of newer treatment strategies and therapeutic protocols. However, this book represents the art and science of head and neck surgery and oncology as well as the current approach to the multidisciplinary management of tumors of the head and neck. Accurate clinical staging of head and neck tumors is crucial to treatment planning and for comparison of outcomes. However, we have deliberately not included the AJCC/UICC staging system in the book due to the anticipated revision of the AJCC/UICC staging system this year. It is expected that the sixth edition of the AJCC/UICC staging manual will be published in the year 2002 and we recommend that the reader refer to this manual for information on details of staging criteria. This book will not only be a valuable resource to aspiring head and neck surgeons and oncologists but also to surgeons, medical oncologists, radiation oncologists, and physicians in other specialties as it will act as a reference volume for current concepts in the management of cancer of the head and neck. Jatin P. Shah, MD August 2001
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Dedication This work is dedicated to our patients who have endured the ravages of head and neck cancer and who have demonstrated extraordinary strength in their struggle to preserve life. These exceptional human beings, who join hands with us in the dogged pursuit of a cure for their cancer and a better quality of life, have a special place in our hearts. We salute their courage, understanding, and perseverance. We are thankful to them for putting their trust and lives in our hands, for giving us the opportunity to understand the disease, and for inspiring us to put this work together.
Acknowledgments I would like to express my sincere appreciation to the American Cancer Society for asking me to edit this volume in their series of clinical atlases. I am equally grateful for the contributions of each of the authors who so willingly and promptly provided up-to-date, generously illustrated, comprehensive but concise chapters on their assigned topics. But for their diligence and promptness, it would not have been possible to compile this work on schedule. My special thanks are owed to Ms. Alice Chen for the artwork in this book, Ms. Nancy Bennett for the graphics and editorial responsibilities, and Ms. Arlene Cooper for transcription of the text. Jatin P. Shah, MD