title: The role of human papillomavirus in the pathogenesis of head & neck squamous cell carcinoma: an overview.
abstract: Cancer statistics report an increased incidence of OSCC and OPSCC around the world. Though improvements in screening and early diagnosis have dramatically reduced the incidence of this neoplasm in recent years, the 5-year-disease-free survival, is still poor, specially for oropharyngeal cancer, despite the great scientific and financial efforts. Recently, several papers showed that HPV may be involved at least in the pathogenesis of a subgroup of oral and cervical SCC, leading to distinct molecular characteristics compared with HPV-negative ones. Nevertheless, OPSCCs associated with HPV infection seem to show a better prognosis and affect younger patients (< 40 yrs.), especially females. Therefore, there is the need to properly assess oropharyngeal SCC subgroups: 1) not HPV associated/classic oral SCC: less responsive to anticancer drugs: needs novel post-surgical treatment; 2) HPV associated/oral SCC: needs several management options and suitable "target" therapy against the virus, and/or immune-stimulating therapy. Further issues are: 1) the disclosure of putative targets for more efficient molecular therapy, which may work as cervical cancer post-surgical treatment, in anticipation of the effects of "global prevention" performed by WHO anti-HPV vaccination programs; 2) careful identification of precancerous lesions in both sites; dysplasia is currently treated by excisional or ablative procedures, which don't consider the concept of field carcinogenesis. In fact, it is probable that near or far from an excised precancerous lesion new foci of cell transformation may exist, which are not yet macroscopically evident, but, if detected, would put the patient into a high risk subgroup.Comparing findings reported in the recent literature, the data of this state of the art about HPV might add useful informations concerning oropharyngeal carcinogenesis. Moreover, our review would be useful in order to define novel perspectives of treatment choice for Head & Neck cancer patients, by combining well known chemotherapeutical drugs with new molecular "target" therapy.
authors: Department of Surgical Sciences - Section of Anatomic Pathology and Cytopathology - University of Foggia - Foggia - Italy.
authors: Giuseppe
authors: G
authors: Pannone
authors: Department of Surgical Sciences, Section of Anatomic Pathology, 'S. Maria Goretti' Hospital - Latina - Italy.|Department of Surgical Sciences - Institute of Anatomic Pathology - University of Bari - Bari - Italy.
authors: Angela
authors: A
authors: Santoro
authors: Department of Otolaryngology - Head and Neck Surgery and Oncology - Medical School, University of Michigan Ann Arbor, Ann Arbor - MI - USA.
authors: Silvana
authors: S
authors: Papagerakis
authors: Department of Surgical Sciences - Section of Oral Pathology - University of Foggia - Foggia - Italy.
authors: Lorenzo
authors: L
authors: Lo Muzio
authors: Section of Pathological Anatomy - Department of biomorphological and functional sciences - University Federico II - Napoli - Italy.
authors: Gaetano
authors: G
authors: De Rosa
authors: Department of Surgical Sciences - Section of Anatomic Pathology and Cytopathology - University of Foggia - Foggia - Italy.
authors: Pantaleo
authors: P
authors: Bufo