Basaloid squamous cell carcinoma of the upper aerodigestive tract: a single squamous cell carcinoma subtype or two distinct entities hiding under one histologic pattern?

Basaloid squamous cell carcinoma of the hypopharynx: an analysis of 213 cases

PURPOSE

Basaloid squamous cell carcinoma (BSCC) is a rare aggressive variant of squamous cell carcinoma (SCC) with a poor prognosis. No large series of exclusively hypopharyngeal BSCC patients have been previously reported. Therefore, this retrospective population-based study aims to explain the patient demographics, clinicopathologic characteristics, incidence, and survival outcomes of hypopharyngeal BSCC and how it relates to conventional-type SCC.

METHODS

The National Cancer Institute's Surveillance, Epidemiology, and End Results database registry was queried for patients diagnosed with hypopharyngeal BSCC and conventional-type SCC between 2001 and 2016.

RESULTS

The incidence of hypopharyngeal BSCC from 2001 to 2016 was 0.0161 per 100,000 individuals. The BSCC group comprised 213 patients, and the SCC group 7958 patients. The majority of BSCCs were considered high grade (Grade III/IV, 89.58%). Most BSCC patients were diagnosed at an advanced stage (American Joint Committee on Cancer [AJCC] stage IV, 65.38%). The 1-, 5-, and 10-year disease-specific survival (DSS) rates for hypopharyngeal BSCC were 84.10%, 57.40%, and 46.20%, respectively. Multivariate analysis, after adjustment for sex, age, race, tumor location, grade, and AJCC stage, showed that patients with BSCC had significantly better DSS than those with conventional-type SCC. Surgery with radiation contributed to a favorable DSS for BSCC patients in comparison with other treatments.

CONCLUSION

This analysis of the largest hypopharyngeal BSCC series indicates a better prognosis for this pathologic type compared with conventional-type hypopharyngeal SCC. Multimodality treatment with surgery and radiation may result in a favorable prognosis for hypopharyngeal BSCC patients.

Unusual Appearance of Basaloid SCC in Tonsil: A Case Report

Basaloid squamous cell carcinoma (BSCC) is a variant of oral squamous cell carcinoma, is an aggressive, high grade variant and rare subtype of the head and neck SCC that less common in tonsils. Here, we are reporting a case of BSCC involving the tonsil with an extension on the cervical lymph node region.

AHNS Series: Do you know your guidelines? Review of current knowledge on laryngeal cancer

The following article is part of a series in an initiative by the American Head and Neck Society's Education Committee and will review clinical practice guidelines for head and neck oncology. The primary goal is to increase awareness of current best practices pertaining to head and neck surgery and oncology. This manuscript is a review of current knowledge in laryngeal cancer with a focus on anatomy, epidemiology, diagnosis, evaluation, and treatment.

Potential impact of human papilloma virus on survival of basaloid squamous carcinoma of the head and neck

OBJECTIVES

Basaloid-squamous-carcinomas (BSCC) have been considered as aggressive variants of common squamous-cell-carcinomas (HNSCC). Recent studies demonstrated a different clinical course depending on the tumour site. The aim of the study is to analyze the histopathologic/clinical features of BSCC/HNSCC resolved by the HPV-status.

METHODS

We analysed the histopathologic/clinical features of BSCC (n=59) and HNSCC (n=981), subdivided due to the HPV status. Differences were analysed using Chi square, Fisher exact, and student's t-test. Survival rates were calculated by Kaplan-Meier and log-rank test. Prognostic variables were subsequently evaluated by Cox regression.

RESULTS

Our cohort was congruent with the literature regarding sex, age, metastases, and a predilection in the oropharynx. HNSCC/BSCC did not show a different disease-specific-survival. After UICC matching, univariate analysis revealed a better survival of UICC stage IVa BSCC compared to HNSCC (69% vs. 42%, p=0.022) that was associated with a better response to radio-chemotherapy (p = 0.009). These results referred to the high prevalence of HPV+ (86%) oropharyngeal BSCC. Subgroup analysis demonstrated a better survival of HPV+ oropharyngeal BSCC than HPV- BSCC (p=0.017).

CONCLUSION

The clinical outcome in BSCC depends on the tumour site and HPV-status. Prospective studies have to evaluate the beneficial application of postoperative radio-chemotherapy in HPV+ BSCC.

Basaloid squamous cell carcinoma of the oropharynx: comparison of two cases and review of the literature

We describe a rare case of BSCC in the retromolar trigone with only 3 other cases in the literature and also compare the differences between 2 cases of BSCC in terms of presentation and progression. The first patient had a markedly slower progression with painful retromolar trigone swelling over 4 months without nodal metastases. In contrast, the second patient gave a 2-week history of neck swelling with nodal involvement, indicating extremely rapid progression. Our management was tailored accordingly with the first patient undergoing intraoral excision of tumour and adjuvant radiotherapy while the other had bilateral neck dissection with postoperative chemoradiotherapy. Both patients achieved good outcome and are free from disease.

Basaloid squamous cell carcinoma of the oral cavity: an analysis of 92 cases

OBJECTIVES/HYPOTHESIS

Basaloid squamous cell carcinoma (BSCC) is considered a rare and possibly more aggressive squamous cell carcinoma (SCC) variant. Until now, a series of exclusively oral cavity BSCC patients has not been previously reported. We endeavored to compare BSCC and SCC of the oral cavity, focusing on epidemiologic factors and survival outcomes.

STUDY DESIGN

Retrospective analysis of population-based data.

METHODS

We compared epidemiologic factors, clinicopathologic data, and disease-specific survivals (DSS) between 92 patients with oral cavity BSCC and 15,181 patients with SCC.

RESULTS

High-grade tumors and distant metastases were more common in the BSCC group (P≤0.001). On multivariable analysis controlling for disease stage, BSCC patients had similar DSS to those with typical SCC (P=0.231). Although there was a trend favoring definitive radiotherapy for BSCC, there were no significant differences in treatment approach between BSCC and SCC. The choice of treatment modality (radiation, surgery±radiation) did not reveal a difference in DSS between the two tumor subtypes.

CONCLUSION

Analysis of the largest oral cavity BSCC series to date demonstrates that BSCC of the oral cavity carries a comparable prognosis to conventional-type oral SCC.

LEVEL OF EVIDENCE

2b.

Basaloid squamous cell carcinoma of oral cavity with incongruent clinical course

Basaloid squamous cell carcinoma (BSCC) is a rare variant of SCC having a marked predilection for the upper aerodigestive tract. It is regarded as a high-grade tumour with increased propensity for metastasis to distant sites. The histological hallmark of BSCC is its dimorphic pattern of presentation with a characteristic basal cell component associated with squamous component. We report two cases of BSCC on the buccal mucosa and gingiva, respectively, with the former presenting as a primary lesion in a patient without a positive history of tobacco and alcohol use and the latter present as a seemingly metachronous development from carcinoma lung. The proliferative index of the two diverse yet similar entities was assessed by Ki-67 labelling index (LI) and the association of human papillomavirus (HPV) was detected with p16 monoclonal antibody. The intrinsically aggressive behaviour of BSCC and its association with HPV is highlighted.

Basaloid Squamous Cell Carcinoma of the Oropharynx

Objective

Basaloid squamous cell carcinoma (BSCC) is considered an aggressive squamous cell carcinoma (SCC) variant. However, we hypothesized that BSCC of the oropharynx may carry a similar prognosis to SCC. A series of exclusively oropharyngeal BSCC patients has not been previously reported. Our objective was to describe the clinical presentation and prognosis of BSCC in a large series of patients with BSCC of the oropharynx and to compare these with a series of patients with conventional-type oropharyngeal SCC.

Study Design

Retrospective analysis of population-based data.

Setting

Data reported by the Surveillance, Epidemiology, and End Results (SEER) program are based on medical records of patients who are treated at academic medical centers, community and county hospitals, and health maintenance organizations.

Subjects and Methods

Clinicopathologic data and disease-specific survival (DSS) were compared between 650 patients with oropharyngeal BSCC and 19,484 with SCC.

Results

High-grade tumors and nodal metastasis were more common in the BSCC group ( P < .02). On multivariable analysis controlling for disease stage, BSCC patients had improved DSS ( P < .001). More BSCC patients received multimodality treatment ( P < .001). Disease-specific survival was similar in BSCC and SCC patients who were treated with primary surgery; however, among patients who received radiotherapy, DSS was better for those with BSCC ( P < .04).

Conclusion

Analysis of the largest oropharyngeal BSCC series to date demonstrates that BSCC of the oropharynx carries a more favorable prognosis than conventional-type oropharyngeal SCC.