BIOLOGICAL STAGING OF HEAD AND NECK-CANCER AND ITS ROLE IN DEVELOPINGEFFECTIVE TREATMENT STRATEGIES

The purpose of a cancer staging system is to encompass all attributes of a tumor that define its life history. We propose a biological stagi ng system which incorporates all of the phases of the natural history of head and neck cancer beginning with the earliest cellular changes e xtending through the early phase of invasion to the occurrence of meta stasis and, finally, culminating in therapeutically refractory disease . This temporally structured system recognizes the importance of const itutional predisposition, and the impact of environmental factors. The intent is to augment the AJCC/UICC staging system and use this system to provide a framework which will easily incorporate current and futu re advances in basic science, prevention, therapy and palliation which will improve the quality and quantity of life for patients.