A. State of the Science Multidisciplinary Tumor Board Concept
Patients with head and neck cancer should be evaluated before initiation of therapy by representatives of each discipline responsible for administering cancer care. Having a multidisciplinary tumor board composed of otolaryngologists, plastic surgeons, oral and maxillofacial surgeons, radiation oncologists, medical oncologists, dental oncologists, pathologists, radiologists, and allied health professionals facilitates this approach. Patients and their family members should attend this tumor board or conference.
After they review the case histories, microscopic slides, and pertinent studies from diagnostic imaging (e.g., computed tomography, magnetic resonance imaging, plain X-ray films), representatives of each discipline should examine the patient. The tumor board process is useful in establishing a correct pathologic diagnosis, determining the extent of disease, detecting other simultaneous head and neck primary cancers that might have escaped detection, and facilitating dental evaluation, which is particularly important in patients whose treatment will include irradiation, chemotherapy, or resection of oral or oropharyngeal tissues.
After examination of the patient, the board should reconvene to discuss therapeutic alternatives and to formulate a recommendation for treatment based on expected outcome (function, cosmesis, impact of treatment on lifestyle and career) and the expertise available at the treating