Prognostic Factors in Squamous Cell Carcinoma of the Head and Neck

Abstract

Therapy for squamous cell carcinoma of head and neck relies on surgery, radiotherapy and chemotherapy, mostly a combination thereof. In patients treated with curative intent, the intensity of therapy is adapted to the supposed prognosis and should be defined upon prognostic factors. Besides classical prognostic parameters, T, N and M stage, the presence of extranodal growth (extracapsular spread, ECS), tumor volume, lymph node burden, extent of tumor necrosis, histologic grading, but also type of treatment were determined in consideration of prognosis. The p53 status does not correlate with prognosis in most investigations. The tumor hypoxia seems to be of prognostic value, and strategies to overcome the adverse effect are currently investigated. Not all factors are relevant for all types of treatment. Besides ECS, these new factors so far have rarely been used to stratify prospective combined modality treatment according to the risk of locoregional and distant failure.

Prediction of Disease-Free Survival in Patients with Squamous Cell Carcinomas of the Head and Neck Using Dynamic Contrast-Enhanced MR Imaging

“…Some studies have reported patients with similar clinical prognostic features exhibiting variable responses and survival rates. 47,48 Therefore, alternate parameters that can stratify patients for optimal treatment protocol are desirable, and we believe that K trans derived from DCE-MRI can be 1 such parameter.…”

Hypoxia Imaging in Gliomas With 18F-Fluoromisonidazole PET: Toward Clinical Translation

“…These studies provide evidence for a relationship between hypoxia, as measured by 18 F-FMISO, and patient survival and are in agreement with a multitude of other cancer studies suggesting the relationship between hypoxia and patient response and prognosis. 14,15,39,52,54,[152][153][154][155] …”

A New Concurrent Chemotherapy with Vinorelbine and Mitomycin C in Combination with Radiotherapy in Patients with Locally Advanced Squamous Cell Carcinoma of the Head and Neck

“…While in early stages many patients can be treated in curative intention and the 5-year overall-survival is as high as 70-90%, locally advanced disease is still difficult to treat. In general, surgery (or radiotherapy, RT) is the favored treatment modality for smaller lesions (T1/T2), whereas more advanced stages (T3/T4, III/IV) are better treated with combined surgery (if possible) and RT [2]. Platinum-based concomitant chemotherapy and RT is superior to conventional RT alone in improving survival in locally advanced squamous cell carcinoma of the head and neck (SCCHN) [3].…”