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Review
. 2023 Sep 3;15(17):4405.
doi: 10.3390/cancers15174405.

Squamous Cell Carcinoma of the Oral Cavity, Oropharynx, and Larynx: A Scoping Review of Treatment Guidelines Worldwide

Lady Paola Aristizabal Arboleda  1 , Genival Barbosa de Carvalho  2 , Alan Roger Santos-Silva  3 , Gisele Aparecida Fernandes  4 , Jose Guilherme Vartanian  2 , David I Conway  5 , Shama Virani  6 , Paul Brennan  6 , Luiz Paulo Kowalski  2   7 , Maria Paula Curado  4
Affiliations
Review

Squamous Cell Carcinoma of the Oral Cavity, Oropharynx, and Larynx: A Scoping Review of Treatment Guidelines Worldwide

Lady Paola Aristizabal Arboleda et al. Cancers (Basel). .

Abstract

Head and neck cancer (HNC) treatments have been based on single or multimodal therapies with surgery, radiotherapy (RT), chemotherapy, and immunotherapy. However, treatment recommendations among countries may differ due to technological/human resources and usual local practices. This scoping review aims to identify, compare, and map the clinical practice guidelines (CPGs) for treating squamous cell carcinoma (SCC) of the oral cavity, oropharynx, and larynx worldwide. A search strategy on global CPGs for HNC was performed by using five electronic databases and grey literature. CPGs were selected for inclusion using EndNote-20 and Rayyan online software. No language or publication date restrictions were applied. The results were analyzed descriptively considering the most updated CPG version. In total, 25 CPGs covering the head and neck region (10), the larynx (7), the oral cavity (5), and the oropharynx (3), were found in 13 geographical regions, and 19 were developed by medical societies from 1996 to 2023. Surgery and RT remain the main modalities for early-stage HNC, with surgery preferred in low-resource countries, and RT in selected cases, especially in the larynx/oropharynx aiming to achieve a cure with organ preservation. Human papillomavirus infection for oropharyngeal SCC is not tested in some Asian countries and there is still no consensus to treat p16-positive cases differently from p16-negative. Recommendations for larynx preservation vary according to facilities in each country, however, individualized choice is emphasized. Inequality across countries/continents is evident, with a similar pattern of recommendations among developed as well as developing ones. No CPGs were found in Latin America as well as Oceania countries, where the incidence of HNC is high and limitations of access to treatment may be encountered.

Keywords: cancer treatment; guidelines; head and neck cancer; larynx cancer; oral cancer; oropharynx cancer; scoping review.

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Conflict of interest statement

The authors declare that they have no conflict of interest related to this work. Where authors are identified as personnel of the International Agency for Research on Cancer/World Health Organization, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policies, or views of the International Agency for Research on Cancer/World Health Organization.

Figures

Figure 1
Figure 1
Flow diagram of literature search and selection criteria adapted from PRISMA 2020 [40].
Figure 2
Figure 2
Societies producing treatment guidelines for head and neck cancer by country. Abbreviation: ACR, American College of Radiology; ASCO, American Society of Clinical Oncology; CPG, Clinical Practice Guidelines; EHNS, European Head and Neck Society; ESMO, European Society for Medical Oncology; ESTRO, European Society for Radiotherapy and Oncology; HNC, Head and neck cancer; KSMO, Korean Society of Medical Oncology; NCCN, National Comprehensive Cancer Network; NICE, National Institute for Health and Care Excellence; SEOM, Spanish Society of Medical Oncology; UK, United Kingdom.
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