Head and Neck Squamous Cell Carcinoma: Update on Epidemiology, Diagnosis, and Treatment

• Published in: Mayo Clinic proceedings Vol. 91; no. 3; pp. 386 - 396
• Main Authors: Marur, Shanthi, MD, Forastiere, Arlene A., MD
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.03.2016; Frontline Medical Communications Inc; Elsevier Limited
• Subjects: Analysis; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - epidemiology; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - therapy; Care and treatment; Combined Modality Therapy; Complications and side effects; Diagnosis; Epidemiology; Head and Neck Neoplasms - diagnosis; Head and Neck Neoplasms - epidemiology; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - therapy; Health aspects; Humans; Internal Medicine; Radiotherapy; Radiotherapy, Adjuvant; Squamous cell carcinoma; United States - epidemiology; United States; RPA; RT; IMRT; IHC; recursive partitioning analysis; HR; OPSCC; HPV; intensity-modulated radiotherapy; transoral robotic surgery; oropharyngeal squamous cell carcinoma; IC; TORS; polymerase chain reaction; ISH; computed tomography; Radiation Therapy Oncology Group; immunohistochemical; CT; HNSCC; human papillomavirus; radiation therapy; hazard ratio; positron emission tomography; RTOG; induction chemotherapy; PCR; PET; head and neck squamous cell carcinoma; in situ hybridization
• ISSN: 0025-6196; 1942-5546
• DOI: 10.1016/j.mayocp.2015.12.017

Abstract Squamous cell carcinoma arises from multiple anatomic subsites in the head and neck region. The risk factors for development of cancers of the oral cavity, oropharynx, hypopharynx, and larynx include tobacco exposure and alcohol dependence, and infection with oncogenic viruses is associated with cancers developing in the nasopharynx, palatine, and lingual tonsils of the oropharynx. The incidence of human papillomavirus–associated oropharyngeal cancer is increasing in developed countries, and by 2020, the annual incidence could surpass that of cervical cancer. The treatment for early-stage squamous cell cancers of the head and neck is generally single modality, either surgery or radiotherapy. The treatment for locally advanced head and neck cancers is multimodal, with either surgery followed by adjuvant radiation or chemoradiation as indicated by pathologic features or definitive chemoradiation. For recurrent disease that is not amenable to a salvage local or regional approach and for metastatic disease, chemotherapy with or without a biological agent is indicated. To date, molecular testing has not influenced treatment selection in head and neck cancer. This review will focus on the changing epidemiology, advances in diagnosis, and treatment options for squamous cell cancers of the head and neck, along with data on risk stratification specific to oropharyngeal cancer, and will highlight the direction of current trials.