A review of histopathologic assessment for head and neck oncologists

With a deeper understanding of histopathologic assessment, head and neck oncology specialists (surgical oncologists, radiation oncologists, and medical oncologists) will be better equipped to address the increasing complexity encompassing head and neck cancer management.

Histopathologic assessment of surgical specimens imparts crucial information that is essential for post-operative treatment planning and prognostication for patients with head and neck squamous cell carcinoma (HNSCC). Herein, we discuss the most current guidelines and recommendations to elucidate the clinically relevant histopathologic features in HNSCC. This review discusses the following pathology features: extranodal extension, margins, perineural invasion, histologic grade, dysplasia, depth of invasion, lymphovascular invasion, and other considerations such as p16 immunohistochemistry, HPV in situ hybridization and worst pattern of invasion.

Understanding histopathology in HNSCC is essential for accurate diagnosis, prognostication, understanding tumor behavior, and treatment management. This complexity of care has led to consensus guidelines from numerous authorities which this paper discusses and summarizes for readers.

The understanding of key histopathology elements in HNSCC will augment multidisciplinary discussions and improve patient care. The current variability in existing consensus guidelines highlights the need for improved standardization of histopathology reporting in HNSCC. Standardization will enhance diagnostic accuracy, guide clinical decision-making, and facilitate the development of more effective treatment strategies.