gms | German Medical Science

Introduction: Basaloid squamous call carcinoma (BSCC) of the head and neck is a rare variant of common SCC with distinct histopathologic features. Consensus on its biological and clinical behavior has not been reached as data about their aggressiveness and survival remain controversial. The aim of this study was to determine the clinical course of BSCC compared to HNSCC and to evaluate the role of HPV.

Methods: From 2001 to 2011, a total of 59 BSCC and 981 HNSCC were treated in our hospital. Patients’ data were reviewed and was set into p16-IHC context.

Results: BSCC occur predominantly in the oropharynx (70%) in elder men (mean age 62 years). The initial rate of cervical node involvement was significantly higher than in the control group (88% and 59%, respectively; p<0.001). The propensity of overall distant metastasis was 18% and 19% in BSCC and HNSCC, respectively, and the recurrence-free interval was also similar with a 5-year-RFI of 58% and 61%, p=0.87. No difference regarding disease-specific survival could be revealed (BSCC vs. HNSCC 5-yr-DSS: 69% and 52%, p=0.06) whereas BSCC had a better outcome when matched according to the UICC stage (69% and 42%, respectively, p=0.02). P16-prevalence in oropharyngeal (O)-BSCC was 75% and 28% in other sites (p<0.001) and was associated with a significant better DSS for both the entire and OBSCC cohort (p=0.015 and p=0.017, respectively).

Conclusion: BSCC show a similar/ better prognosis than SCC in dependence of the stage and the rates of oropharyngeal lesions as p16-prevalence in OBSCC tends to be higher than in common HNSCC and causes a significant better outcome then HPV-negative OBSCC.

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