Oropharyngeal cancer: Optimal therapeutic approach not easily defined

No valid comparative studies
- Surgery +/- postoperative (chemo)radiation
- Primary chemoradiation
No single therapeutic regimen offers clear-cut, superior survival advantage
Optimal approach aims for
- Single modality treatment for early tumours
- Minimum treatment morbidity and mortality
- Optimal functional outcome (swallowing, speech)
- Cost-efficiency
Therapeutic choice therefore requires
- Careful review of each case
  - Staging
  - General physical condition
  - Emotional reserves
  - Social and financial support
  - Likelihood of regular follow-up
- Availability of supportive care (including nutrition), speech and swallowing rehabilitation and salvage treatment
- Experience of treating team