Micrometastasis by K. Pantel

By K. Pantel

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CONCLUSION AND FUTURE DIRECTIONS In the past few years, much progress has been made in our understanding of the molecular progression of primary human cancers. Characterizing the molecular progression of a particular tumour type is critical in order to provide markers for diagnostic molecular assays. Using the appropriate marker or panel of markers would then provide information about the presence or absence of (minimal) residual cancer or unresected premalignant lesions, at this moment theoretically the best prognosticators of relapse in head and neck cancer.

19. 20. 21. Franceschi D, Gupta R, Spiro RH, Shah JP. Improved survival in the treatment of squamous carcinoma of the oral tongue. Am J Surgery. 1993;166:360–5. Zarbo RJ, Crissman JD. The surgical pathology of head and neck cancer. Seminars in Oncology. 1988;15:10–19. Alvi A, Johnson JT. Development of distant metastasis after treatment of advancedstage head and neck cancer. Head & Neck. 1997;19:500–5. Vikram B. Changing patterns of failure in advanced head and neck cancer. Arch Otolaryngol. 1984;110:564–5.

The presence of these large lesions in the resection margins indicated a contiguous mutated-p53 field of mucosal epithelium (see Figure 2). These lesions (genetically altered mucosal lesions or ‘fields’) might represent the phenomenon of ‘field cancerization’ (43). As only part of the head and neck cancers show a p53 mutation, and p53 mutations (or at least accompanying 17p LOH) are not the earliest changes, we could not exclude that we only detected part of the tumour-related genetically altered fields surrounding HNSCC.

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