Is open surgery for head and neck cancers truly declining?

Area of Science:

• Oncology
• Surgical Oncology
• Head and Neck Surgery

Background:

• Major advancements in medical oncology and technology have altered head and neck cancer treatment over the past two decades.
• A decrease in tobacco/alcohol-related squamous cell carcinoma of the pharynx and larynx is observed, alongside an increase in human papillomavirus-related oropharyngeal tumors.

Purpose of the Study:

• To analyze the evolving trends in surgical treatment modalities for head and neck cancers.
• To identify the impact of technological and epidemiological shifts on surgical approaches.

Main Methods:

• Review of treatment trends over the past two decades.
• Analysis of changes in the incidence of various head and neck tumors.
• Assessment of the adoption of minimally invasive and technology-based surgical techniques.

Main Results:

• Open surgery use has declined as first-line treatment for certain head and neck cancers.
• Minimally invasive endoscopic surgery and non-surgical options have increased.
• Open surgery remains primary for skin, oral cavity, sinonasal, skull base, salivary gland, thyroid, and sarcoma tumors.
• Rates of open surgery have increased for oral cavity, thyroid, and skin cancers, with more neck dissections and reconstructive procedures.
• Use of technology-assisted surgery (lasers, robots, etc.) has risen.

Conclusions:

• Head and neck cancer treatment is dynamic, with a trend towards less invasive procedures for some sites.
• Open surgery remains crucial for specific tumor types, and its application has increased in certain areas.
• Future head and neck surgeons' skills will be influenced by ongoing technological, epidemiological, and biological advancements.