Is oral squamous cell carcinoma unique in terms of intra- and inter-tumoral heterogeneity?

Tumoral heterogeneity has become one of the important issues in cancer research and carries outmost weightage in designing personalized cancer medicine. Oral squamous cell carcinoma (OSCC) is present in unique microenvironment of oral cavity attributed to site-specific diversified tissue compositions, microbial flora, diversified carcinogenic attacks, potentially malignant disorders, epithelial turnover rate, saliva, and closeness to external environment. Such microenvironment has potential to modulate the pathogenesis of many oral pathologies including OSCC. We believe that such factors and microenvironment are unique for OSCC and cannot be found in other carcinomas of the body. Methodologies such as multiregional sequencing, single-cell genomics, genomic landscape of bulk tumor sequencing, and so on, will help in understanding OSCC uniqueness in terms of heterogeneity. If explored, it will enable us to know the attributes of heterogeneity and their magnitude in OSCC, which will benefit in designing predictable biomarker and effective therapeutic strategy.