Molecular approaches to the staging of head and neck carcinomas (review)

Despite the efforts during the last decades to improve clinical management and therapy, carcinomas of the head and neck still represent a disease with an unfavourable course. Over 50% of the patients die from their disease within 5 years after diagnosis, with tumour recurrence, metastasis, and development of second primary neoplasms as major causes of treatment failure. In addition, surgical treatment of locally advanced disease often results in invalidating and disfiguring conditions that heavily affect patients' quality of life. Current criteria of tumour staging, essentially based on clinical and pathological assessment, fail to prove effective in providing reliable information on tumour prognosis or supporting an optimized planning of the therapies, prompting the identification of new and more accurate staging criteria. This review focuses on the impact of molecular biology in HNSCC staging, namely differentiation of second primary lesions from recurrence/metastasis and detection of lymph node micrometastasis, and highlights how the integration of the histopathological diagnosis with molecular analyses may result in a better management of HNSCC patients.