Head and neck squamous cell carcinoma is a significant contributor to the global cancer burden, with a high cancer-specific mortality. Although the Union for International Cancer Control (UICC)/American Joint Committee on Cancer (AJCC) 8th edition TNM staging systems for head and neck cancer has shown improved performance when compared with previous systems, this classification, however, still remains largely insufficient. While TNM staging is focused on prediction of overall survival using well-established, historical criteria, there have been several successful attempts to improve staging by incorporating pathological, radiological, genomic and other novel biomarkers. This serves several purposes: to improve precision and accuracy in the existing staging system, to sub-stratify patients within a stage to predict survival more accurately, and to identify patients who are candidates for treatment escalation through clinical trials and other novel strategies.
The argument against increasing complexity in staging is that it needs to remain simple, widely applicable and easily reproducible, and introducing novel biomarkers into the staging criteria prevents that. However it is important to acknowledge that as our insight into the etiology and pathogenesis of these cancers improves, our staging of these patients needs to reflect this. Next-generation head and neck cancer staging represents the understanding the role that novel markers are likely to play in the diagnosis and treatment of head and cancers. Patient-specific models allow incorporating these factors in to patient prognostication and treatment planning; in other cancers, such as breast and prostate, these have become a common part of practice, while in head and neck, they have not yet become wide accepted.
The purpose of this series of articles is to explore the likely future trends in head and neck cancer staging. It will focus on radiological, pathological, genomic and other novel biomarkers that allow us to move beyond the traditional, one-dimensional concept of staging only predicting survival. We invite articles that focus on the next generation of head and neck cancer staging, and are interested in approaches that include (but are not limited to) radiomics, biomarkers like neutrophil/lymphocyte ratios or circulating tumor cells, proteomics, and biomarkers related to immunotherapy response. While some of these, like adverse pathological features, are well suited to incorporation into future iterations of the staging system, while others are better suited to improving decision-making for individual patients. We are open to research related to novel imaging techniques, pathological or proteomic biomarkers, markers of treatment resistance, and other factors that help stratify or prognosticate patients with head and neck squamous cell carcinoma (including nasopharyngeal carcinoma).
Suggested topics:
• Incorporation of pathological or immunohistochemical features in HNSCC staging
• Novel radiomics or imaging-based markers that improve staging or predict outcomes
• Novel markers of treatment resistance with radiotherapy or chemotherapy
• Predictors of immunotherapy response
Please note: manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of scope for this section and will not be accepted as part of this Research Topic.
Head and neck squamous cell carcinoma is a significant contributor to the global cancer burden, with a high cancer-specific mortality. Although the Union for International Cancer Control (UICC)/American Joint Committee on Cancer (AJCC) 8th edition TNM staging systems for head and neck cancer has shown improved performance when compared with previous systems, this classification, however, still remains largely insufficient. While TNM staging is focused on prediction of overall survival using well-established, historical criteria, there have been several successful attempts to improve staging by incorporating pathological, radiological, genomic and other novel biomarkers. This serves several purposes: to improve precision and accuracy in the existing staging system, to sub-stratify patients within a stage to predict survival more accurately, and to identify patients who are candidates for treatment escalation through clinical trials and other novel strategies.
The argument against increasing complexity in staging is that it needs to remain simple, widely applicable and easily reproducible, and introducing novel biomarkers into the staging criteria prevents that. However it is important to acknowledge that as our insight into the etiology and pathogenesis of these cancers improves, our staging of these patients needs to reflect this. Next-generation head and neck cancer staging represents the understanding the role that novel markers are likely to play in the diagnosis and treatment of head and cancers. Patient-specific models allow incorporating these factors in to patient prognostication and treatment planning; in other cancers, such as breast and prostate, these have become a common part of practice, while in head and neck, they have not yet become wide accepted.
The purpose of this series of articles is to explore the likely future trends in head and neck cancer staging. It will focus on radiological, pathological, genomic and other novel biomarkers that allow us to move beyond the traditional, one-dimensional concept of staging only predicting survival. We invite articles that focus on the next generation of head and neck cancer staging, and are interested in approaches that include (but are not limited to) radiomics, biomarkers like neutrophil/lymphocyte ratios or circulating tumor cells, proteomics, and biomarkers related to immunotherapy response. While some of these, like adverse pathological features, are well suited to incorporation into future iterations of the staging system, while others are better suited to improving decision-making for individual patients. We are open to research related to novel imaging techniques, pathological or proteomic biomarkers, markers of treatment resistance, and other factors that help stratify or prognosticate patients with head and neck squamous cell carcinoma (including nasopharyngeal carcinoma).
Suggested topics:
• Incorporation of pathological or immunohistochemical features in HNSCC staging
• Novel radiomics or imaging-based markers that improve staging or predict outcomes
• Novel markers of treatment resistance with radiotherapy or chemotherapy
• Predictors of immunotherapy response
Please note: manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of scope for this section and will not be accepted as part of this Research Topic.