Tumor markers in squamous cell carcinoma of the head and neck: clinical effectiveness and prognostic value

Despite recent advances in tumor surgery and multimodal treatment regimens the prognosis of squamous cell carcinomas of the head and neck is still relatively poor and has shown only slow progress. Additional clinical and biological factors are therefore urgently needed that aid tumor diagnosis, early detection of tumor recurrences, prediction of the results of therapeutic interventions, and identification of subsets of patients with unfavorable outcome during follow-up. A tumor marker should fulfill the criteria of specificity and clinical effectiveness. So far none of the known serological and biological markers fits all these criteria. Although some biological markers can be determined serologically without the need for tumor tissue, their low specificity limits their applicability to early detection of tumor recurrences during follow-up. A large number of molecular or genetic markers have been examined in squamous cell carcinomas of the head and neck. All of these are controversial regarding their prognostic value and clinical effectiveness. UICC tumor stage and patient’s age and performance still remain the basis for therapeutic decisions. Further search for more sensitive and specific markers is needed to improve individual treatment and prognostic statements.