Head and neck squamous cell carcinoma (HNSCC) is well known as a serious health problem worldwide, especially in low-income countries or those with limited resources, such as most countries in Latin America. International guidelines cannot always be applied to a population from a large region with specific conditions. This study established a Latin American guideline for care of patients with head and neck cancer and presented evidence of HNSCC management considering availability and oncologic benefit. A panel composed of 41 head and neck cancer experts systematically worked according to a modified Delphi process on (1) document compilation of evidence-based answers to different questions contextualized by resource availability and oncologic benefit regarding Latin America (region of limited resources and/or without access to all necessary health care system infrastructure), (2) revision of the answers and the classification of levels of evidence and degrees of recommendations of all recommendations, (3) validation of the consensus through two rounds of online surveys, and (4) manuscript composition. The consensus consists of 12 sections: Head and neck cancer staging, Histopathologic evaluation of head and neck cancer, Head and neck surgery—oral cavity, Clinical oncology—oral cavity, Head and neck surgery—oropharynx, Clinical oncology—oropharynx, Head and neck surgery—larynx, Head and neck surgery—larynx/hypopharynx, Clinical oncology—larynx/hypopharynx, Clinical oncology—recurrent and metastatic head and neck cancer, Head and neck surgery—reconstruction and rehabilitation, and Radiation therapy. The present consensus established 48 recommendations on HNSCC patient care considering the availability of resources and focusing on oncologic benefit. These recommendations could also be used to formulate strategies in other regions like Latin America countries.

Authors: Leandro Luongo Matos, MD, PhD https://orcid.org/0000-0002-5068-8208 l.matos@fm.usp.br, Luiz Paulo Kowalski, MD, PhD https://orcid.org/0000-0002-0481-156X, Aline Lauda Freitas Chaves, MD, MSc https://orcid.org/0000-0002-6759-9463, Thiago Bueno de Oliveira, MD, PhD https://orcid.org/0000-0002-6472-3596, Gustavo Nader Marta, MD, PhD https://orcid.org/0000-0002-3298-3684, Maria Paula Curado, MD, PhD https://orcid.org/0000-0001-8172-2483, Gilberto de Castro Junior, MD, PhD https://orcid.org/0000-0001-8765-3044, Terence P. Farias, MD, MSc, PhD https://orcid.org/0000-0001-7287-5736, Gustavo Sarria Bardales, MD https://orcid.org/0000-0002-7459-7730, Mario Avila Cabrera, MD, Renato de Castro Capuzzo, MD, MSc https://orcid.org/0000-0003-1221-5503, Genival Barbosa de Carvalho, MD, PhD https://orcid.org/0000-0001-8741-3278, Claudio Roberto Cernea, MD, PhD https://orcid.org/0000-0001-5899-0535, Rogério Aparecido Dedivitis, MD, PhD https://orcid.org/0000-0002-6267-1147, Fernando Luiz Dias, MD, PhD https://orcid.org/0000-0003-1000-7436, Andrés Munyo Estefan, MD https://orcid.org/0000-0002-3863-3845, Agustin Horacio Falco, MD https://orcid.org/0000-0003-4487-2444, Gustavo Alberto Ferraris, MD, PhD https://orcid.org/0000-0003-3862-9296, Alejandro Gonzalez-Motta, MD https://orcid.org/0000-0003-0990-0657, Andre Guimarães Gouveia, MD, MBA https://orcid.org/0000-0001-7055-3557, Alexandre Arthur Jacinto, MD, PhD https://orcid.org/0000-0002-6353-2202, Marco Aurelio Vamondes Kulcsar, MD, PhD https://orcid.org/0000-0002-4751-0476, Ana Kober Leite, MD, PhD https://orcid.org/0000-0001-7814-757X, Renan Bezerra Lira, MD, PhD https://orcid.org/0000-0002-1461-9053, Milena Perez Mak, MD, PhD https://orcid.org/0000-0001-5876-6533, Pedro De Marchi, MD, PhD https://orcid.org/0000-0001-5259-0215, Evandro Sobroza de Mello, MD, PhD https://orcid.org/0000-0002-4383-2910, Fátima Cristina Mendes de Matos, MD, PhD https://orcid.org/0000-0002-9135-8117, Pablo H. Montero, MD https://orcid.org/0000-0002-1297-9469, Eduardo Dias de Moraes, MD https://orcid.org/0009-0007-1330-3288, Fabio Ynoe de Moraes, MD, PhD https://orcid.org/0000-0003-3407-9215, Diego Chaves Rezende Morais, MD, MSc https://orcid.org/0000-0002-0592-2114, Fernando Miguel Poenitz, MD, Adela Poitevin, MD https://orcid.org/0000-0001-7841-2652, Hernán Ortiz Riveros, MD https://orcid.org/0000-0001-9454-0056, Álvaro Sanabria, MD, MSc, PhD https://orcid.org/0000-0002-5563-8840, Miguel Ticona-Castro, MD https://orcid.org/0000-0002-3021-6385, José Guilherme Vartanian, MD, PhD https://orcid.org/0000-0003-1995-6742, Gustavo Viani, MD, PhD https://orcid.org/0000-0002-4337-7575, Eugenio F. Vines, MD https://orcid.org/0000-0003-3246-6094, William Nassib William Junior, MD https://orcid.org/0000-0001-5008-8854, David Conway, BDS, MPH, PhD https://orcid.org/0000-0001-7762-4063, Shama Virani, PhD https://orcid.org/0000-0002-1163-432X, and Paul Brennan, PhD https://orcid.org/0000-0002-0518-8714, HEADSpAcE Consortium