The heretofore unnoticed observation that patients carrying HNSCC with AChE activity below the cut-off value have a poorer survival rate (Fig. 1) reminds very much the case of hepatocellular carcinoma patients, for which a low level of AChE activity was found to be correlated with an increased risk of post-operative recurrence [23]. This evidence concerns the gene ACHE and head and neck squamous cell carcinoma.