Atlas Oncology Surgery.pdf

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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)


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Atlas of

Clinical Oncology

Editors

GLENN D. STEELE JR, MDGeisinger 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


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Atlas of

Clinical Oncology

Cancer of the

Head and NeckEditor

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 CenterNew York, New York

Illustrator

Alice Y. Chen

2001

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2001 American Cancer Society

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PETERE. 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, MDAssistant Attending Surgeon


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



New York Presbyterian Hospital;

Assistant Professor



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


New York, New York

Head and Neck Radiation Oncology

PETERG. CORDEIRO, MD, FACS

Associate Attending Surgeon

Plastic and Reconstructive Surgery Service


Associate Professor of Surgery

Department of Surgery


New York, New York

General Principles of Reconstructive Surgeryfor Head and Neck Cancer

Mandible Reconstruction

BRUCE J. DAVIDSON, MD, FACS

Assistant Professor

Deartment of Otolaryngology


Georgetown University Medical Center

Washington, District of Columbia

Epidemiology and Etiology

JOSEPH J. DISA, MD


Plastic and Reconstructive Surgery Service


Assistant Professor



New York, New York

General Principles of Reconstructive Surgery

for Head and Neck Cancer


ANDREW G. HUVOS, MD

Attending Pathologist


Professor of Pathology


New York, New York

Pathology of Head and Neck Tumors

Contributors

v


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vi 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, PennsylvaniaCancer of the Hypopharynx and Cervical

Esophagus

DENNIS H. KRAUS, MD, FACS

Associate Attending Surgeon



Associate Professor



Weill Medical College of Cornell UniversityNew York, New York

Cancer of the Nasal Cavity and Paranasal Sinuses


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. OMALLEY, 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 ServiceMemorial 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


Associate Professor, Department of MedicineWeill Medical College of Cornell University

New York, New York

Chemotherapy and Chemoprevention in


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


Oregon Health Sciences University

Portland, Oregon

Management of Cervical Metastasis


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CONTRIBUTORS vii

ERIC SANTAMARIA, MD

Associate Professor


Hospital General Dr. Manuel Gea Gonzalez

Mexico City, Mexico

General Principles of Reconstructive Surgery

for Head and Neck Cancer


JATIN P. SHAH, MD, FACS

Chief and Attending Surgeon

Elliot W. Strong Chair in Head and Neck Oncology



Professor, Department of Surgery


New York, New YorkSkin Cancers of the Head and Neck

Tumors of the Oropharynx


Neurogenic and Vascular Tumors of the

Head and Neck

Soft Tissue and Bone Tumors

ASHOKR. SHAHA, MD, FACS

Attending Surgeon


Memorial Sloan-Kettering Cancer Center;Professor, Department of Surgery


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, PennsylvaniaChemotherapy and Chemoprevention in


BHUVANESH SINGH, MD




Assistant Professor




New York, New York

Skin Cancers of the Head and Neck

Rehabilitation and Quality of Life Assessment in


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 ServiceMemorial Sloan-Kettering Cancer Center

New York, New York

Salivary Tumors

ELLIOT W. STRONG, MD, FACS

Professor Emeritus



New York, New York

Oral Cavity Cancer

SUZANNE L. WOLDEN, MD

Assistant Attending Radiation Oncologist


Assistant Professor of Radiation Oncology


New York, New York

Cancer of the Nasopharynx

RICHARD J. WONG, MD

Fellow, Head and Neck Service

Memorial Sloan-Kettering Cancer CenterNew York, New York

Cancer of the Nasal Cavity and Paranasal Sinuses

IAN M. ZLOTOLOW, DMD

Chief and Attending Dental Surgeon

Dental Service


New York, New York

Dental Oncology and Maxillofacial Prosthetics


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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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57Bernard B. OMalley, 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

Contents

viii
http://docs/ch01.pdfhttp://docs/ch01.pdfhttp://docs/ch02.pdfhttp://docs/ch02.pdfhttp://docs/ch03.pdfhttp://docs/ch03.pdfhttp://docs/ch03.pdfhttp://docs/ch03.pdfhttp://docs/ch04.pdfhttp://docs/ch04.pdfhttp://docs/ch05.pdfhttp://docs/ch05.pdfhttp://docs/ch06.pdfhttp://docs/ch06.pdfhttp://docs/ch07.pdfhttp://docs/ch07.pdfhttp://docs/ch08.pdfhttp://docs/ch08.pdfhttp://docs/ch09.pdfhttp://docs/ch09.pdfhttp://docs/ch10.pdfhttp://docs/ch10.pdfhttp://docs/ch11.pdfhttp://docs/ch11.pdfhttp://docs/ch11.pdfhttp://docs/ch10.pdfhttp://docs/ch09.pdfhttp://docs/ch08.pdfhttp://docs/ch07.pdfhttp://docs/ch06.pdfhttp://docs/ch05.pdfhttp://docs/ch04.pdfhttp://docs/ch03.pdfhttp://docs/ch02.pdfhttp://docs/ch01.pdf


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CONTENTS ix

12 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
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Although oral cancer is the sixth most common cancer worldwide, cancer of the head and neck is a rare dis-

ease 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 under-

standing 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 UnitedStates 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 can-

cer. 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 prac-

titioner 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 perma-

nently 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 plan-

ning 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 recommendthat 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 oncolo-

gists, 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

Preface

x


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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.


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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 chap-

ters on their assigned topics. But for their diligence and promptness, it would not have been possible to com-

pile 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

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