Hypoxia, a characteristic feature of locally advanced solid tumors, has emerged as a key factor of the tumor pathophysiome, since it can promote tumor progression and resistance to therapy. Independent of established prognostic parameters, such as clinical tumor stage, histology, histological grade and nodal status, hypoxia has been identified as an adverse prognostic factor for patient outcome. Studies of pretreatment tumor hypoxia involving direct assessment (polarographic oxygen tension measurements) have suggested a poor prognosis for patients with hypoxic tumors. These investigations indicate a worse disease-free survival for patients with hypoxic cancers of the uterine cervix or soft tissue sarcomas. In head & neck cancers, the studies suggest that pretherapeutic hypoxia is prognostic for survival and local control.