Head and Neck Squamous Cell Cancer: Approach to Staging and Surveillance

This chapter addresses the rising global burden of Head and Neck Squamous Cell Cancer (HNSCC), a heterogeneous group of cancers in the upper aerodigestive tract. We focus on the pivotal role of imaging modalities like CT, MRI, PET/CT, and US in the early detection, accurate staging, and management of HNSCC. The discussion includes the nuances of TNM staging, key upstaging features, and the evolving role of advanced imaging techniques such as MR/PET. The chapter highlights significant updates in the AJCC/UICC eighth edition, particularly concerning HPV-related cancers and the depth of invasion in oral cavity SCC. Special attention is given to the challenges in diagnosing Neck Cancer of Unknown Primary (NCUP), underlining the importance of integrated imaging, clinical exam, and molecular markers. Overall, the chapter emphasizes the essential role of radiologists in the comprehensive management of HNSCC, combining imaging insights with clinical findings for optimal patient care.