It should be noted that EMT is a reversible trans-differentiation program with inherent plasticity associated with the stemness of cancer cells sharing considerable redundancies such as mediators, factors, signal transducers and these are not induced simultaneously, We identified that the co-overexpression of TWIST1-CSF1 drives biologically aggressive phenotype in a pure epithelial cell population (our samples were microdissected) from patients with oral cancer presenting very similar clinicopathological characteristics and outcomes. This evidence concerns the gene TWIST1 and lip and oral cavity carcinoma.