Possibilities and limitations of palliative surgery in head and neck cancer patients

Background Incurable head and neck cancer causes distressing symptoms that significantly reduce patients' quality of life. Objective The aim of this article is to present the surgical possibilities and their limitations in a palliative setting. Materials and methods A literature review was performed and supplemented with the authors' own experiences. Results Smaller endoscopic procedures for tumor debulking or hemostasis are possible to reduce symptoms and improving quality of life, which should be the aim of palliative care. To preserve swallowing function and breathing, the insertion of stents is a feasible alternative to tracheotomy. However, even larger tumor resections with reconstruction by pedicled or free grafts may be justified. Conclusion Especially in the palliative setting, patients and their individual complaints are the primary focus. Therefore, the indications for surgery should be discussed with the patient and his relatives, preferentially interdisciplinarily. Due to considerable progress, particularly in the field of systemic tumor therapy, extended surgical procedures with reconstruction are losing some of their importance in the palliative situation.