With the exception of human papilloma virus-16 (HPV-16) associated cancers, the 5-year survival rate of head and neck squamous cell carcinoma (HNSCC) patients has not improved during the past three decades, and recurrence rates and morbidity associated with therapy remain high. The major reasons attributed to the limited survival rate are late diagnosis, disease recurrence, distant metastasis and resistance to therapy. In particular, even for HPV-16 related cancers, cause of cancer death is primarily from distant metastases that may be related to cancer stem cell biology.
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