Prognosis and predictive factors in head-and-neck cancers

• Published in: Bulletin du cancer Vol. 96; no. 4; p. 369
• Main Authors: Cojocariu, O M, Huguet, F, Lefevre, M, Périé, S
• Format: Journal Article
• Language: French
• Published: France 01.04.2009
• Subjects: Anemia - etiology; Carcinoma, Squamous Cell - metabolism; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - therapy; Carcinoma, Squamous Cell - virology; Cell Hypoxia; Genes, p53 - genetics; Head and Neck Neoplasms - metabolism; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - therapy; Head and Neck Neoplasms - virology; Humans; Laryngeal Neoplasms - metabolism; Laryngeal Neoplasms - pathology; Laryngeal Neoplasms - therapy; Laryngeal Neoplasms - virology; Lymphatic Metastasis; Mouth Neoplasms - metabolism; Mouth Neoplasms - pathology; Mouth Neoplasms - therapy; Mouth Neoplasms - virology; Nasopharyngeal Neoplasms - metabolism; Nasopharyngeal Neoplasms - pathology; Nasopharyngeal Neoplasms - therapy; Nasopharyngeal Neoplasms - virology; Neoplasm Proteins - antagonists & inhibitors; Neoplasm Proteins - metabolism; Neoplasm Staging; Otorhinolaryngologic Neoplasms - metabolism; Otorhinolaryngologic Neoplasms - pathology; Otorhinolaryngologic Neoplasms - therapy; Otorhinolaryngologic Neoplasms - virology; Papillomavirus Infections - complications; Papillomavirus Infections - virology; Paranasal Sinuses; Pharyngeal Neoplasms - metabolism; Pharyngeal Neoplasms - pathology; Pharyngeal Neoplasms - therapy; Pharyngeal Neoplasms - virology; Prognosis; Receptor, Epidermal Growth Factor - antagonists & inhibitors; Receptor, Epidermal Growth Factor - metabolism; Tumor Burden
• ISSN: 1769-6917
• DOI: 10.1684/bdc.2009.0777

The head-and-neck squamous-cell carcinomas (HNSCC) represent in order of frequency the fourth leading cause of cancer deaths among men in France. The term HNSCC includes various anatomopathological and clinical entities with different evolution patterns. For this reason, it is necessary to identify prognostic and predictive factors able to help in the choice of the treatment. The clinical factors with a prognostic value are the tumor location, the tumor size and the lymph node status. The degree of differentiation is the most important histologic factor. More recently, the identification of molecular factors has opened the way to new therapies. Thus, the overexpression of EGFR is associated with a poor prognosis. Its inhibition improves the survival of patients. p53 mutations and cyclin D1 amplification are actually subject to intensive research. The tumors associated with HPV infection are distinguishable by a better prognosis. 18-alpha-FDG positron emission tomography emerges as a useful tool for the therapeutic evaluation. The evolution of surgical techniques, the development of induction chemotherapy regimen or concurrent ones with radiotherapy and new techniques of conformal irradiation also results in a better locoregional control.