Defining response-adapted surgery after neoadjuvant therapy in oral cavity cancer Review
| Authors: | Cracchiolo, J. R.; Starc, M. T.; Wong, R. J.; Ho, A.; Ganly, I.; Pfister, D. G.; Lee, N.; Wong, W.; Tam, K.; Cohen, M. A.; Dunn, L. |
| Review Title: | Defining response-adapted surgery after neoadjuvant therapy in oral cavity cancer |
| Abstract: | Background: Response-adapted surgery in oncology refers to surgical planning that considers a patient's response to neoadjuvant therapy. To advance the study of this strategy and for integration into routine clinical care, rigorous documentation of any response-adapted changes in surgery performed is needed. Methods and Results: We searched the medical literature and identified a gap in research into response-adapted surgery. We set out to describe a classification for documentation of the proposed resection at initial presentation and following neoadjuvant treatment at time of resection of locoregionally advanced oral cavity cancers. We based this classification upon the surgical anatomy of the oral cavity. We have divided the adaptations into structures resected, exposure lymph node basin management, and reconstruction. Using expert opinion, we developed the surgical morbidity score. This classification was reviewed and endorsed by the head and neck disease management team at our institution for use in all patients with oral cavity cancer treated with neoadjuvant strategies. Conclusions: The proposed classification will allow for the use of consistent terminology to define response-adapted surgery in patients with locoregionally advanced oral cavity cancer treated with a neoadjuvant approach prior to definitive surgery. This uniform classification will facilitate improved communication between head and neck oncologists, comparison between published studies, and consistency in the development of clinical trial endpoints incorporating organ preservation as a vital health-related quality of life outcome. © 2025 Elsevier Ltd |
| Keywords: | cancer surgery; advanced cancer; cancer growth; systemic therapy; neoadjuvant therapy; pathology; lymph node; surgery; organ preservation; tongue cancer; mouth neoplasms; tracheostomy; mouth cancer; therapy; mouth cavity; oral cavity cancer; mouth tumor; procedures; reconstructive surgery; humans; human; article; response adapted surgery |
| Journal Title: | Oral Oncology |
| Volume: | 165 |
| ISSN: | 1368-8375 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2025-06-01 |
| Start Page: | 107349 |
| Language: | English |
| DOI: | 10.1016/j.oraloncology.2025.107349 |
| PUBMED: | 40339433 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF. Corresponding MSK author is Jennifer R. Cracchiolo -- Source: Scopus |
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