John A. Ridge, MD, PhD, FACS, Editor

The term “head and neck cancer” describes a diverse group of tumors arising in the upper aerodigestive tract. The overwhelming majority are squamous cell carcinomas caused by substance abuse, although viral causes are increasingly recognized. In aggregate, they constitute the seventh most common malignancy worldwide (more than half a million will be diagnosed this year) and the ninth most common cancer in North America. Some 60,000 Americans will develop head and neck cancers during the coming year, and perhaps 12,000 will succumb to the disease. Though not commonly considered “head and neck cancers,” salivary gland tumors and cutaneous malignancies (including melanoma) also represent significant clinical problems.

To a great degree, squamous carcinomas arising from the mucosal surfaces of the head and neck (“head and neck cancers”), salivary gland tumors, and cutaneous malignancies are properly Halstedian cancers. They are largely characterized by an orderly progression from the primary site, through regional nodal involvement, to distant metastases. Seldom “systemic” at presentation, the diseases described in this issue of Surgical Oncology Clinics of North America are curable through local and regional therapy alone. The treatment regimens, whether surgical or radiation-based, are satisfying to deliver, and many patients survive their disease.

As with most diseases, our understanding of the epidemiology, molecular biology, and immunology of head and neck tumors is increasing rapidly. Considerable excitement surrounds the characterization of a new disease (oropharyngeal cancer induced by human papilloma virus) and the application of newly developed immunotherapeutic agents. Performance of a head and neck examination is essential in evaluating any patient suspected of harboring a cancer arising between the dura and the pleura, as is an appropriate selection of imaging studies. A multidisciplinary approach is necessary for all but the smallest and most indolent of these lesions, and a close working relationship between all oncologists (surgical, medical, reconstructive, and radiation) is indispensible.

This issue provides a thorough background in the topics introduced above before addressing in detail individual diseases, including cancers of the oral cavity, oropharynx, unknown primary, larynx and hypopharynx, nasopharynx, nose and sinuses, skin cancers, and salivary gland tumors. There is something for everyone.

My distinguished coauthors and I could not have prepared this issue of Surgical Oncology Clinics of North America without the dedicated assistance of Meredith Clinton and the team at Elsevier. I would like to thank them for their commitment to the endeavor, and Nicholas Petrelli for inviting me to participate.