%0 Journal Article %T Basics of tumor development and importance of human papilloma virus (HPV) for head and neck cancer [] %A Wittekindt %A Claus %A Wagner %A Steffen %A Mayer %A Christina Sabine %A Klussmann %A Jens Peter %J GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery %D 2012 %I German Medical Science, D¨¹sseldorf %R 10.3205/cto000091 %X [english] Head and Neck Squamous Cell Carcinomas (HNSCC) are the 6 most common cancers worldwide. While incidence rates for cancer of the hypopharynx and larynx are decreasing, a significant increase in cancer of the oropharynx (OSCC) is observed. Classical risk factors for HNSCC are smoking and alcohol. It has been shown for 25 to 60% of OSCC to be associated with an infection by oncogenic human papilloma viruses (HPV). The development of ¡°common¡± cancer of the head and neck is substantially enhanced by an accumulation of genetic changes, which lead to an inactivation of tumor suppressor genes or activation of proto-oncogenes. A more or less uniform sequence of different DNA-damages leads to genetic instability. In this context, an early and frequent event is deletion on the short arm of chromosome 9, which results in inactivation of the p16-gene. In contrast, for HPV-induced carcinogenesis, expression of the viral proteins E6 and E7 is most important, since they lead to inactivation of the cellular tumor-suppressor-proteins p53 and Rb. The natural route of transoral infection is a matter of debate; peroral HPV-infections might be frequent and disappear uneventfully in most cases. Smoking seems to increase the probability for developing an HPV-associated OSCC. The association of HNSCC with HPV can be proven with established methods in clinical diagnostics. In addition to classical prognostic factors, diagnosis of HPV-association may become important for selection of future therapies. Prognostic relevance of HPV probably surmounts many known risk-factors, for example regional metastasis. Until now, no other molecular markers are established in clinical routine. Future therapy concepts may vary for the two subgroups of patients, particularly patients with HPV-associated OSCC may take advantage of less aggressive treatments. Finally, an outlook will be given on possible targeted therapies. %K head and neck cancer %K human papillomavirus %K carcinogenesis %K prognosis %K molecular markers %U http://www.egms.de/static/en/journals/cto/2012-11/cto000091.shtml