Oral Squamous Cell Carcinoma: Advances in Diagnosis, Therapy, and Salivary Biomarkers

Abstract

Oral squamous cell carcinoma (OSCC) is one of the most prevalent malignancies of the oral cavity and remains a significant global health concern because of its aggressive progression, potential for regional and distant metastasis, and considerable impact on patients’ quality of life. Despite improvements in clinical assessment and therapeutic interventions, delayed diagnosis and disease recurrence continue to present major challenges in effective disease management. This review examines recent advances in the diagnosis, treatment, and identification of salivary biomarkers for OSCC, emphasizing their potential contribution to early detection, accurate disease characterization, and personalized clinical care. Conventional diagnostic approaches, including comprehensive oral examination, histopathological assessment, and tissue biopsy, remain fundamental to establishing a definitive diagnosis. However, emerging technologies, such as advanced imaging techniques, molecular profiling, artificial intelligence-assisted diagnostic systems, and genomic analysis, are expanding opportunities for earlier and more precise identification of malignant lesions. Particular attention is directed toward salivary biomarkers, including proteins, microRNAs, circulating cell-free nucleic acids, metabolites, and inflammatory mediators, which may provide a non-invasive and patient-friendly approach to cancer screening, monitoring, and prognostic evaluation. The review also explores contemporary therapeutic strategies, encompassing surgical resection, radiotherapy, chemotherapy, targeted molecular therapies, and immunotherapy, alongside emerging treatment combinations designed to improve therapeutic response and reduce recurrence. Furthermore, the integration of molecular biomarkers with clinical and pathological findings may facilitate risk stratification, treatment selection, and longitudinal monitoring of disease progression. Nevertheless, the translation of promising biomarkers into routine clinical practice remains constrained by variations in sample collection, analytical methods, patient characteristics, and validation protocols, as well as the limited availability of large-scale prospective studies. Addressing these limitations through standardized methodologies, multicentre investigations, and clinically representative validation studies is essential to establish the diagnostic reliability and practical utility of salivary biomarkers. Overall, integrating technological innovations, molecular diagnostics, and individualized treatment approaches offers considerable potential to improve the early detection and management of OSCC. Continued interdisciplinary research may ultimately support more accessible diagnostic pathways, optimized therapeutic decisions, and improved clinical outcomes for patients affected by this malignancy.