Excerpt

There is no single universal definition of the upper aerodigestive tract; for the purposes of this guideline, it encompasses the oral cavity, oropharynx, nasopharynx, hypopharynx, larynx, and paranasal sinuses. The vast majority of cancers at these sites are squamous cell carcinomas (National Head and Neck Cancer Audit, 2014). Some other cancers with less common histological diagnoses, such as mucosal melanomas of the upper aerodigestive tract, are also covered by this guideline.

Contents

• Foreword
• Key research recommendations
• Methodology
• Pictorial representation of the diagnostic recommendations
• 1. Needs Assessment
  • 1.1. Introduction
  • 1.2. Incidence and prevalence
  • 1.3. Risk Factors
  • 1.4. Diagnosis and treatment
  • 1.5. Survivorship and long-term effects of cancer treatment
  • References
• 2. Information and support
  • 2.1. Information needs
  • 2.2. Smoking cessation
  • References
• 3. Investigation
  • 3.1. Assessment of neck lumps
  • 3.2. Identifying the occult primary
  • 3.3. Clinical staging – who and how?
  • References
• 4. Treatment of early stage disease
  • 4.1. Squamous cell carcinoma of the larynx
  • 4.2. Management of the N0 neck in T1–2 squamous cell carcinoma of the oral cavity
  • 4.3. Squamous cell carcinoma of the oropharynx (T1–T2, N0)
  • References
• 5. Treatment of advanced disease
  • 5.1. Squamous cell carcinoma of the larynx
  • 5.2. Squamous cell carcinoma of the hypopharynx
  • 5.3. Palliation of breathing difficulties
  • References
• 6. HPV-related disease
  • 6.1. HPV testing
  • 6.2. De-intensification of treatment
  • References
• 7. Less-common upper aerodigestive tract cancers
  • 7.1. Carcinoma of the nasopharynx
  • 7.2. Carcinoma of the paranasal sinuses
  • 7.3. Unknown primary of presumed upper aerodigestive tract origin
  • 7.4. Mucosal melanoma
  • References
• 8. Optimising function and rehabilitation
  • 8.1. Enteral nutrition support
  • 8.2. Speech and language therapy interventions
  • 8.3. Shoulder rehabilitation
  • References
• 9. Follow-up of people with cancer of the upper aerodigestive tract and the management of osteoradionecrosis (ORN)
  • 9.1. Follow-up
  • 9.2. Management of ORN
  • References
• Appendices
  • Appendix A. The cost-effectiveness of systemic imaging for distant metastases in patients with cancer of the upper aerodigestive tract?
  • Appendix B. The cost-effectiveness of initial treatments for newly diagnosed T1 or T2 carcinoma of the larynx?
  • Appendix C. The Cost-Effectiveness of Management Strategies for the Clinically and Radiologically N0 Neck
  • Appendix D. Abbreviations
  • Appendix E. Glossary
  • Appendix F. Guideline Scope
  • Appendix G. People and organisations involved in production of the guideline
  • Appendix H. Evidence Review

Disclaimer: Healthcare professionals are expected to take NICE clinical guidelines fully into account when exercising their clinical judgement. However, the guidance does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of each patient, in consultation with the patient and/or their guardian or carer.