Head & Neck Cancer

Drs. Ambrosch and Brinck appropriately emphasize the problems and limitations encountered when using routine pathologic procedures to examine lymph nodes from head and neck cancer specimens. Extraordinary processing techniques have repeatedly yielded a larger number of small nodes and, on occasion, have demonstrated the presence of micrometastases. The majority of these observations come from examination of breast specimens and their axillary dissections. Labor-intensive clearing techniques have varied to some extent, but generally involve progressive removal of opaque fat with alcoholic solvents of increasing percentages culminating in absolute alcohol (100%). Final visualization involves submerging the defatted specimen in cedarwood oil, followed by careful examination and dissection of the backlighted specimen.

MENLO PARK, Calif--Matrix Pharmaceutical, Inc. has begun phase III clinical testing of its IntraDose-CDDP injectable gel (see image) for treatment of recurrent head and neck cancer and other accessible tumors.

Management of the neck lymph nodes is a critical factor in the success of treatment for patients with malignant head and neck tumors. Recurrence in the neck is an important cause of treatment failure, second in frequency only to recurrence at the primary site [1,2].

Dr. Stringer has done an excellent job of reviewing the anatomic, biologic, diagnostic, and therapeutic considerations that impact on the management of nodal metastases from head and neck malignancies. This is a thorough summary of the current

This article will address modified, selective, and radical neck dissection as well as other surgical considerations, and will review the surgical techniques currently available for neck treatment.