From Radical Resection to Precision Surgery: Integrating Diagnostic Biomarkers, Radiomics-Based Predictive Models,...

Area of Science:

• Oncology
• Surgical Oncology
• Genomics

Background:

• Head and neck cancer surgery has shifted from radical procedures to function-preserving methods.
• Multidisciplinary care frameworks now integrate advanced diagnostic technologies.

Purpose of the Study:

• To review the evolving role of surgery in head and neck cancer.
• To examine diagnostic methodologies for treatment selection and response prediction.
• To highlight the integration of genomic profiling and imaging biomarkers.

Main Methods:

• Comprehensive literature review of studies from the past five years, with inclusion of historical and recent publications.
• Analysis of diagnostic technologies including comprehensive genomic profiling, imaging biomarkers (radiomics, quantitative ultrasound, habitat imaging), and machine learning algorithms.

Main Results:

• Comprehensive genomic profiling identifies actionable alterations in >90% of head and neck squamous cell carcinomas.
• Tumor mutational burden and PD-L1 scores are validated predictive biomarkers for immunotherapy.
• Radiomics and habitat imaging models show high accuracy (>85%) in predicting treatment response and radiation sensitivity.
• Integration of diagnostics enables adaptive strategies, reducing adjuvant therapy in HPV-associated cancers.

Conclusions:

• Validated diagnostic platforms facilitate precise treatment selection and response prediction in head and neck cancer surgery.
• Precision medicine approaches are transforming surgical practice towards function preservation.
• Further standardization and prospective trials are needed to demonstrate survival benefits and ensure broader implementation.