Brian Cervenka1, Patrik Pipkorn2, Johannes Fagan3, Mark Zafereo4, Joyce Aswani5, Chege Macharia6, Innocent Kundiona7, Victor Mashamba8, Chad Zender9, Michael Moore10. 1. Department of Otolaryngology-Head and Neck Surgery, University of California at Davis, Resident, Sacramento, California. 2. Department of Otolaryngology-Head and Neck Surgery, Washington University, Assistant Professor, St. Louis, Missouri. 3. Department of Otolaryngology-Head and Neck Surgery, The University of Cape Town, Professor, Cape Town, South Africa. 4. Department of Head and Neck Surgery, The University of Texas, MD Anderson Cancer Center, Associate Professor, Houston, Texas. 5. Department of Otolaryngology-Head and Neck Surgery, University of Nairobi, Nairobi, Kenya. 6. Department of General Surgery, AIC Kijabe Hospital, Kijabe, Kenya. 7. Department of Surgery, The University of Zimbabwe, Harare, Zimbabwe. 8. Department of Otorhinolaryngology, Muhimbili National Hospital, Dar es Salaam, Tanzania. 9. Department of Otolaryngology-Head and Neck Surgery, Case Western Reserve MC, Cleveland, Ohio. 10. Department of Otolaryngology-Head and Neck Surgery, University of California at Davis, Associate Professor, Sacramento, California.
Abstract
BACKGROUND: The diagnosis and management of oral cavity cancer has been well described in developed countries, however, in regions with fewer medical resources, alternative methods may need to be used. We outline an approach to evaluation and treatment of oral cavity cancer in low-resource areas. METHODS: Reviews of the Cochrane and Pubmed databases were performed and literature compiled. Expert opinions from the American and African Head and Neck Societies were also provided. RESULTS: Treatment guidelines for managing oral cavity cancer in low-resource regions are outlined and the level of supporting evidence is defined. DISCUSSION: Successful treatment typically involves the use of upfront surgical resection of the primary lesion and any involved or at-risk cervical lymph node basins, with adjuvant therapy based on the final pathology findings. In situations where services such as adjuvant therapy and/or appropriate reconstruction are not available, alternative approaches to treatment may be needed.
BACKGROUND: The diagnosis and management of oral cavity cancer has been well described in developed countries, however, in regions with fewer medical resources, alternative methods may need to be used. We outline an approach to evaluation and treatment of oral cavity cancer in low-resource areas. METHODS: Reviews of the Cochrane and Pubmed databases were performed and literature compiled. Expert opinions from the American and African Head and Neck Societies were also provided. RESULTS: Treatment guidelines for managing oral cavity cancer in low-resource regions are outlined and the level of supporting evidence is defined. DISCUSSION: Successful treatment typically involves the use of upfront surgical resection of the primary lesion and any involved or at-risk cervical lymph node basins, with adjuvant therapy based on the final pathology findings. In situations where services such as adjuvant therapy and/or appropriate reconstruction are not available, alternative approaches to treatment may be needed.