Optimal Adjuvant Therapy of Head and Neck Squamous Cancer After Primary Surgical Resection

Optimal selection of patients for adjuvant therapy following primary surgery for head and neck squamous cancer is challenging. Decision-making depends on a range of patient and disease factors including the presence or otherwise of a host of pathologic risk factors. Postoperative radiotherapy is the standard of care for advanced disease and has a role for early-stage disease in the presence of multiple risk factors. Concurrent chemotherapy improves outcomes for high-risk pathology having extranodal extension and/or very close/positive margins, and in these patients, immunotherapy in the perioperative period is associated with better locoregional control. Adjuvant therapy has significant toxicity.